Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | C.1700264 | OH |
NPI | 1003315821 |
---|---|
Provider Name | Wendolyn Sueann Ross |
First Address | New Albany, OH 43054-9215 |
Second Address | Columbus, OH 43220-2690 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2018 |
Last Update Date | 10/09/2018 |