Provider Demographics
NPI:1578880217
Name:ROSS, WEDNESDAY (LMSW)
Entity Type:Individual
Prefix:
First Name:WEDNESDAY
Middle Name:
Last Name:ROSS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6141
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-5104
Mailing Address - Country:US
Mailing Address - Phone:972-546-0551
Mailing Address - Fax:972-540-0791
Practice Address - Street 1:8003 SILVERADO TRL
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-6822
Practice Address - Country:US
Practice Address - Phone:972-546-0551
Practice Address - Fax:972-540-0791
Is Sole Proprietor?:No
Enumeration Date:2010-04-20
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41675104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker