Provider Demographics
NPI:1538335096
Name:ROSS, ERICA OWEN
Entity type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:OWEN
Last Name:ROSS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TN
Mailing Address - Zip Code:38242-5413
Mailing Address - Country:US
Mailing Address - Phone:731-641-4141
Mailing Address - Fax:
Practice Address - Street 1:107 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TN
Practice Address - Zip Code:38242-5413
Practice Address - Country:US
Practice Address - Phone:731-641-4141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health