MEDICARE: CAROL JEAN ROSS LPC

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	12043	AZ

General Provider Information

NPI Number	:	1548494982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL JEAN ROSS LPC

Provider Business Mailing Address
First Line	:	2292 W MAGEE RD
Second Line	:	SUITE 260
City	:	TUCSON
State	:	AZ
Zip	:	85742-4301
Country	:	US
Telephone Number	:	520-405-1471
Fax Number	:	520-544-8312

Provider Business Practice Location Address
First Line	:	2292 W MAGEE RD
Second Line	:	SUITE 260
City	:	TUCSON
State	:	AZ
Zip	:	85742-4301
Country	:	US
Telephone Number	:	520-405-1471
Fax Number	:	520-544-8312

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

Provider Enumeration Date	:	05/13/2009
Last Update Date	:	05/13/2009

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Directions to “ CAROL JEAN ROSS LPC” Practice Location

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