Individual
MIMI ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17999 W SURPRISE FARMS LOOP S, SURPRISE, AZ 85388-6641
(623) 876-7350
Mailing address
17999 W. SURPRISE FARMS LOOP SOUTH, SURPRISE, AZ 85388-6641
(623) 876-7350
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SLPA6304
AZ
Other
Enumeration date
01/14/2010
Last updated
01/14/2010
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