Organization
CLINICAL & FORENSIC PSYCHOLOGICAL SERVICES OF INDIANA, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN GERARD ROSS PSYD (PSYCHOLOGIST)
(260) 436-4100
Entity
Organization
Contact information
Practice address
4630 W JEFFERSON BLVD, SUITE 5, FORT WAYNE, IN 46804-6856
(260) 436-4100
(260) 432-6282
Mailing address
4630 W JEFFERSON BLVD, SUITE 5, FORT WAYNE, IN 46804-6856
(260) 436-4100
(260) 432-6282
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20040536A
IN
Other
Enumeration date
05/23/2007
Last updated
03/03/2008
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