Individual
JASMIRA IVONTE ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCMHCA
Contact information
Practice address
309 CRUTCHFIELD ST, DURHAM, NC 27704-2754
(919) 560-7305
(919) 797-1962
Mailing address
2701 N 16TH ST STE 316, PHOENIX, AZ 85006-1266
(602) 845-0049
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A16060
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A16060
LICENSE
NC
Enumeration date
06/11/2021
Last updated
09/27/2021
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