Provider Demographics
NPI:1275837783
Name:ROSS, BARBARA JO (MED)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:JO
Last Name:ROSS
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 2ND ST
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-4552
Mailing Address - Country:US
Mailing Address - Phone:814-207-0536
Mailing Address - Fax:
Practice Address - Street 1:3010 7TH AVE
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-1906
Practice Address - Country:US
Practice Address - Phone:814-942-9425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-28
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health