Individual
TAMIKA ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ST
Contact information
Practice address
707 TRINITY LN, RIDGELAND, MS 39157-1296
(601) 502-6222
Mailing address
707 TRINITY LN, RIDGELAND, MS 39157-1296
(601) 502-6222
Taxonomy
Speciality
Code
Description
License number
State
225500000X
Respiratory/Developmental/Rehabilitative Specialist/Technologist
S2907
MS
235Z00000X
Speech-Language Pathologist
Primary
S2907
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01901799
—
MS
01
—
4250496048A
BCBS GROUP
MS
Enumeration date
05/21/2007
Last updated
05/17/2013
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