Provider Demographics
NPI:1386078079
Name:ROSS, MELISSA JEAN (MS)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:JEAN
Last Name:ROSS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:HOPE VALLEY
Mailing Address - State:RI
Mailing Address - Zip Code:02832-2000
Mailing Address - Country:US
Mailing Address - Phone:401-741-8775
Mailing Address - Fax:401-781-0945
Practice Address - Street 1:2733 POST RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886
Practice Address - Country:US
Practice Address - Phone:401-921-4825
Practice Address - Fax:401-921-4918
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-29
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist