Individual
MISTY ROSS I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2705 PARK RIDGE DR, PARAGOULD, AR 72450-6013
(870) 931-2418
Mailing address
2705 PARK RIDGE DR, PARAGOULD, AR 72450-6013
(870) 931-2418
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
05/12/2017
Last updated
05/12/2017
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