Provider Demographics
NPI:1164779070
Name:ROSS, AIMEE DANIELLE (MSW)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:DANIELLE
Last Name:ROSS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:622 ROE AVE
Mailing Address - Street 2:
Mailing Address - City:WARRENSBURG
Mailing Address - State:MO
Mailing Address - Zip Code:64093
Mailing Address - Country:US
Mailing Address - Phone:801-803-8554
Mailing Address - Fax:
Practice Address - Street 1:10704 E WESTPORT RD
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64052-3470
Practice Address - Country:US
Practice Address - Phone:816-699-2526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-09
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011030685104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker