Individual
JUSTIN ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
4144 E AMITY AVE, NAMPA, ID 83687-8802
(208) 465-4985
Mailing address
2181 W ASTONTE ST, MERIDIAN, ID 83646-7693
(208) 447-6290
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-5495
ID
Other
Enumeration date
11/18/2015
Last updated
11/18/2015
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