Doctor Name: | IRIS FAE ROSS |
NPI Number: | 1942424254 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, L.P.C. |
License Number: | 001830 |
Business Practice Address: | 110 N. Second St. Ellington, MO - 63638 |
Business Phone Number: | 5736632988 |
Business Fax Number: | 5736633431 |
Mailing Address: | Rt 4 Box 4264, PIEDMONT |
State: | MO |
Postal Code: | 63957 |
Phone Number: | 5738564991 |
Fax Number: | 5736633431 |
NPI Enumeration Date: | 04/11/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 001830 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |