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General NPI Number Information
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NPI Number | 1275258071
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Entity Type | Individual
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Provider Name | MICHELLE THOMAS-ROSS MSW, LISW
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Gender | Female
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Dates
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Enumeration Date | 10/05/2022
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Last Update Date | 10/10/2023
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Provider Practice Location Address
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Address Line | 2708 GRAND AVE
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City | DES MOINES
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State | IA
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Zip | 50312-5218
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Country | US
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Telephone | 515-957-1692
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Fax |
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Provider Business Mailing Address
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Address Line | 6010 NE 12TH AVE
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City | PLEASANT HILL
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State | IA
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Zip | 50327-8804
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Country | US
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Telephone | 515-822-2371
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 06770
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License Number State | IA
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