Provider Demographics
NPI:1891362919
Name:ROSS, LEI ANN (AUD)
Entity Type:Individual
Prefix:DR
First Name:LEI
Middle Name:ANN
Last Name:ROSS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:LEI
Other - Middle Name:ANN
Other - Last Name:BRIST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10201 KANIS RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6203
Mailing Address - Country:US
Mailing Address - Phone:501-227-5050
Mailing Address - Fax:
Practice Address - Street 1:500 S UNIVERSITY AVE STE 423
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5348
Practice Address - Country:US
Practice Address - Phone:501-664-4381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR201422231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist