Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
N | 101YM0800X | Mental Health Counselor | ||
Y | 101YP2500X | Professional Counselor | APC007878 | GA |
N | 101YS0200X | School Counselor |
NPI | 1003496928 |
---|---|
Provider Name | Mrs. Meagan Ross |
First Address | Auburn, GA 30011-2556 |
Second Address | Auburn, GA 30011-2556 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2021 |
Last Update Date | 13/04/2021 |