Individual
EBONI ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
51229 CENTURY CT, WIXOM, MI 48393-2074
(313) 938-8380
Mailing address
22493 CHIPPEWA ST, DETROIT, MI 48219-1112
(313) 938-8380
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/23/2023
Last updated
01/23/2023
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