Individual
JODY ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
521 E 86TH AVE STE H, MERRILLVILLE, IN 46410-6236
(219) 323-3311
Mailing address
13234 HAMMERHILL WAY, FORT WAYNE, IN 46845-2351
(260) 479-7207
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
10/26/2021
Last updated
10/26/2021
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