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Individual

BRYON L ROSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
6655 E US HIGHWAY 36, AVON, IN 46123-8923
(317) 272-3330
(317) 272-0807
Mailing address
250 N SHADELAND AVE STE 200, INDIANAPOLIS, IN 46219-4959
(317) 962-3834

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34002964A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000489634
ANTHEM BCBS PROVIDER PIN
IN
Enumeration date
02/15/2006
Last updated
03/11/2020
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