Provider Demographics
NPI:1578838421
Name:ROSS, NICOLA TONEY (BS; MED)
Entity Type:Individual
Prefix:MS
First Name:NICOLA
Middle Name:TONEY
Last Name:ROSS
Suffix:
Gender:F
Credentials:BS; MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 WOODBROOK CT
Mailing Address - Street 2:
Mailing Address - City:CAMERON
Mailing Address - State:NC
Mailing Address - Zip Code:28326-8860
Mailing Address - Country:US
Mailing Address - Phone:703-966-3215
Mailing Address - Fax:
Practice Address - Street 1:25 WOODBROOK CT
Practice Address - Street 2:
Practice Address - City:CAMERON
Practice Address - State:NC
Practice Address - Zip Code:28326-8860
Practice Address - Country:US
Practice Address - Phone:703-966-3215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-11
Last Update Date:2012-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist