Healthcare Provider Details

I. General information

NPI: 1740729243
Provider Name (Legal Business Name): MICHELE ROSS PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/16/2017
Last Update Date: 11/08/2023
Certification Date: 11/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3321 PLEASANT DR
MIDWEST CITY OK
73110-3823
US

IV. Provider business mailing address

6608 N WESTERN AVE # 1440
OKLAHOMA CITY OK
73116-7326
US

V. Phone/Fax

Practice location:
  • Phone: 405-455-8216
  • Fax:
Mailing address:
  • Phone: 405-455-8216
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: