Individual
JENNA M ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSCSW
Contact information
Practice address
400 N WOODLAWN ST STE 100, WICHITA, KS 67208-4331
(316) 685-9311
(316) 633-4283
Mailing address
1421 E 2ND ST N, WICHITA, KS 67214-4119
(316) 685-9311
(316) 633-4283
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4984
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201104250C
—
KS
Enumeration date
11/17/2014
Last updated
08/30/2019
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