Individual
TOMMACIA ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
229 SW MAIN BLVD, LAKE CITY, FL 32025-7049
(386) 515-3009
Mailing address
229 SW MAIN BLVD, LAKE CITY, FL 32025-7049
(386) 515-3009
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
05/04/2018
Last updated
07/25/2023
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