Individual
MRS. KELLY B. ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5900 GOODMAN RD., SUITE B, OLIVE BRANCH, MS 38654
(901) 270-3542
(815) 377-3622
Mailing address
6268 SPRING XING, OLIVE BRANCH, MS 38654-5812
(901) 270-3542
(815) 377-3622
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C5689
MS
Other
Enumeration date
09/30/2009
Last updated
10/02/2009
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