Individual
MARY ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC SLP
Contact information
Practice address
1310 GREEN ACRES DR SW, CORYDON, IN 47112-5300
(812) 972-5839
Mailing address
1310 GREEN ACRES DR SW, CORYDON, IN 47112-5300
(812) 972-5839
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22006604A
IN
Other
Enumeration date
04/19/2017
Last updated
04/19/2017
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