| Doctor Name: | TONYETTA L ROSS |
| NPI Number: | 1003132473 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SACIT |
| License Number: | 15896-130 |
| Business Practice Address: | 3537 N 57th St Milwaukee, WI - 532162819 |
| Business Phone Number: | 4146900672 |
| Business Fax Number: | |
| Mailing Address: | 3537 N 57th St, MILWAUKEE |
| State: | WI |
| Postal Code: | 532162819 |
| Phone Number: | 4146900672 |
| Fax Number: | |
| NPI Enumeration Date: | 04/10/2010 |
| NPI Last Update Date: | 05/14/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 15896-130 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |