Most Relevant Information
Provider Data
| NPI Number: | 1003233412 |
| Provider Name: | LETICIA ROSS |
| Entity Type: | Individual |
| Taxonomy Code: | 101YP2500X |
| Specialty: | Counselor |
| License Number: | 708 INTERN NUMBER |
Most Important Dates
| Enumeration Date: | 03/24/2014 |
| Last Updated: | 03/24/2014 |
Provider Practice Location
11616 HAWTHORNE BLVD
SUITE 202
HAWTHORNE
CA
902502366
Practice Location Phone/Fax
| Phone: | 3235731128 |
| Fax: | 3106450023 |
Provider Mailing Location
11616 HAWTHORNE BLVD
SUITE 202
HAWTHORNE
CA
902502366
Provider Mailing Phone/Fax
| Phone: | 3235731128 |
| Fax: | 3106450023 |