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General NPI Number Information
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NPI Number | 1851453781
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Entity Type | Individual
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Provider Name | SANDRA KAY ROSS M.R.C., L.P.C.
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Gender | Female
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Dates
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Enumeration Date | 12/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2913 KING ST SUITE 4
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City | JONESBORO
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State | AR
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Zip | 72401-5322
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Country | US
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Telephone | 870-972-8883
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 19135
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City | JONESBORO
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State | AR
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Zip | 72403-9135
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Country | US
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Telephone | 870-972-8883
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | P0107027
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License Number State | AR
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