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Individual

MS. LISA ANN ROSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
600 N OLIVE ST, MEDIA, PA 19063-2418
(610) 566-7540
(610) 566-7677
Mailing address
2400 HOLLIS RD, HAVERTOWN, PA 19083-1522
(610) 924-0609

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
CW01490PA
PA
1041C0700X
Clinical Social Worker
CW01490
PA

Other

Enumeration date
10/04/2006
Last updated
08/18/2008
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