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General NPI Number Information
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NPI Number | 1801601703
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Entity Type | Individual
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Provider Name | JESSICA F ROSS LMSW
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Gender |
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Dates
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Enumeration Date | 02/10/2025
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 1030 FAYETTEVILLE RD SE
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City | ATLANTA
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State | GA
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Zip | 30316-2921
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Country | US
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Telephone | 404-486-9034
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Fax |
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Provider Business Mailing Address
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Address Line | 2035 MEMORIAL DR SE APT 2001
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City | ATLANTA
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State | GA
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Zip | 30317-2528
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Country | US
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Telephone | 330-800-6880
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | MSW012346
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License Number State | GA
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