Individual
JESSICA A ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2548 E KENOSHA ST, BROKEN ARROW, OK 74014-6712
(618) 623-9089
Mailing address
2548 E KENOSHA ST, BROKEN ARROW, OK 74014-6712
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200323940
—
OK
Enumeration date
06/06/2017
Last updated
01/30/2026
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