MEDICARE: ROSS MILLS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1033987078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSS MILLS

Provider Business Mailing Address
First Line	:	746 ROBINSON FARMS DR
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30068-3281
Country	:	US
Telephone Number	:	706-338-3893
Fax Number	:

Provider Business Practice Location Address
First Line	:	1730 MOUNT VERNON RD STE G
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30338-4245
Country	:	US
Telephone Number	:	770-815-6853
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/19/2023
Last Update Date	:	12/19/2023

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Directions to “ ROSS MILLS ” Practice Location

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