Provider Demographics
NPI:1841346335
Name:ROSS, RITA V (SST)
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:V
Last Name:ROSS
Suffix:
Gender:F
Credentials:SST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:289 HAMILTON PLEASANT GROV RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:GA
Mailing Address - Zip Code:31811-5909
Mailing Address - Country:US
Mailing Address - Phone:706-628-4740
Mailing Address - Fax:706-628-7608
Practice Address - Street 1:2100 COMER AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-8725
Practice Address - Country:US
Practice Address - Phone:706-596-5586
Practice Address - Fax:706-596-5589
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical