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General NPI Number Information
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NPI Number | 1447608591
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Entity Type | Individual
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Provider Name | LANETTA DOROSE ROSS LPC/LCDC
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Gender | Female
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Dates
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Enumeration Date | 05/31/2016
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Last Update Date | 09/04/2018
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Provider Practice Location Address
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Address Line | 1229 E PLEASANT RUN RD STE 219
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City | DESOTO
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State | TX
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Zip | 75115
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Country | US
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Telephone | 972-765-1514
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Fax | 855-301-8724
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Provider Business Mailing Address
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Address Line | 866 RAINTREE LN
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City | DESOTO
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State | TX
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Zip | 75115-7525
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Country | US
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Telephone | 972-965-8802
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Fax | 972-230-2118
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 5388
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 71895
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License Number State | TX
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