Individual
TRACY M ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.DIV.
Contact information
Practice address
4218 GUION LAKES TER, INDIANAPOLIS, IN 46254-1594
(317) 664-1390
Mailing address
PO BOX 53224, INDIANAPOLIS, IN 46253-0224
(317) 664-1390
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201034050A
—
IN
Enumeration date
04/11/2008
Last updated
11/11/2011
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