Ross, Thalia

Ross, Thalia is an sole proprietor health care provider with primary practice located at 1912 Central Dr Suite A, Bedford TX 76021-5894. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Ross, Thalia can be contacted via phone (817) 718-8576.

Contact Information

Primary practice address
1912 Central Dr Suite A Bedford TX 76021-5894
Fax: (817) 451-1763
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 30812 Texas

Profile Details

NPI number 1104049055
LBN Legal business name Ross, Thalia
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 10th, 2007
Last updated Dec 29th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104049055 NPPES
Texas Other TXB131437 MEDICARE
Texas MEDICAID 184916803 MEDICARE

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