Individual
MALISHA LULAIDA ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAS-A
Contact information
Practice address
5212 GRASS RIDGE DR, CHARLOTTE, NC 28216-2970
(704) 430-4250
(704) 823-8751
Mailing address
5212 GRASS RIDGE DR, CHARLOTTE, NC 28216-2970
(704) 430-4250
(704) 853-8751
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2494-A
NC
Other
Enumeration date
10/15/2012
Last updated
10/15/2012
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