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NPI Code Detail

MEDICARE: MRS. DEBBI LYNNE ROSS

MEDICARE: MRS. DEBBI LYNNE ROSS
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
1103TC0700XClinical PsychologistL1808685MI

General Provider Information

NPI Number : 1992009468
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DEBBI LYNNE ROSS
Provider Business Mailing Address
First Line : 6520 WHYSALL RD
Second Line :
City : BLOOMFIELD HILLS
State : MI
Zip : 48301-2849
Country : US
Telephone Number : 248-932-3350
Fax Number :
Provider Business Practice Location Address
First Line : 2122 15 MILE RD
Second Line : B
City : STERLING HEIGHTS
State : MI
Zip : 48310-4853
Country : US
Telephone Number : 586-264-3692
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/27/2010
Last Update Date : 12/27/2010

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