Individual
REBECCA ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5235 N IRONWOOD RD, GLENDALE, WI 53217-4906
(414) 902-1500
Mailing address
PO 04188, MILWAUKEE, WI 53204
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
18130130
WI
Other
Enumeration date
04/06/2017
Last updated
04/06/2017
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