Individual
ANDREA LEE ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2227 N COLLEGE AVE, FAYETTEVILLE, AR 72703-2804
(479) 396-8228
Mailing address
PO BOX 264, FAYETTEVILLE, AR 72702-0264
(479) 396-8228
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
9565-M
AR
1041C0700X
Clinical Social Worker
Primary
9565-C
AR
1041C0700X
Clinical Social Worker
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Other
Enumeration date
03/21/2007
Last updated
09/19/2023
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