Individual
HEATHER ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
E7475 RAWHIDE RD, NEW LONDON, WI 54961-9025
(920) 531-2654
Mailing address
E7475 RAWHIDE RD, NEW LONDON, WI 54961-9025
(920) 538-5834
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
8657-123
WI
Other
Enumeration date
10/17/2014
Last updated
01/24/2023
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