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General NPI Number Information
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NPI Number | 1003563131
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Entity Type | Organization
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Legal Business Name | JAMIE ROSS, LICENSED MARRIAGE AND FAMILY THERAPIST, PLLC
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Dates
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Enumeration Date | 03/08/2022
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Last Update Date | 03/08/2022
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Provider Practice Location Address
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Address Line | 220 LAKE AVE STE 1
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City | SAINT JAMES
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State | NY
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Zip | 11780-2979
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Country | US
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Telephone | 631-312-7123
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Fax | 631-265-0757
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Provider Business Mailing Address
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Address Line | 220 LAKE AVE STE 1
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City | SAINT JAMES
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State | NY
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Zip | 11780-2979
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Country | US
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Telephone | 631-312-7123
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Fax | 631-265-0757
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Authorized Official
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Title or Position | OWNER, LMFT
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Name | MRS. JAMIE ANN ROSS
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Credential | LMFT
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Telephone | 631-312-7123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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