Individual
MAISIE ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
909 E STATE BLVD, FORT WAYNE, IN 46805-3404
(260) 481-2700
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34011562A
IN
Other
Enumeration date
02/21/2025
Last updated
03/14/2025
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