Individual
DR. STEPHEN GERARD ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
4630 W JEFFERSON BLVD STE 5, FORT WAYNE, IN 46804-6800
(260) 436-4100
(260) 432-6282
Mailing address
4630 W JEFFERSON BLVD STE 5, FORT WAYNE, IN 46804-6800
(260) 436-4100
(260) 432-6282
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20040536A
IN
Other
Enumeration date
06/22/2005
Last updated
04/14/2008
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