Individual
MR. MARK ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SAC-IT
Contact information
Practice address
5408 N 40TH ST, MILWAUKEE, WI 53209-4618
(414) 881-2342
Mailing address
5408 N 40TH ST, MILWAUKEE, WI 53209-4618
(414) 881-2342
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
11/25/2015
Last updated
11/25/2015
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