| Clinical & Forensic Psychological Services Of Indiana, P.c. | |
|
4630 W Jefferson Blvd Suite 5 Fort Wayne IN 46804-6856 | |
| (260) 436-4100 | |
| (260) 432-6282 |
| Full Name | Clinical & Forensic Psychological Services Of Indiana, P.c. |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 4630 W Jefferson Blvd, Fort Wayne, Indiana |
| Authorized Official Name and Position | Stephen Gerard Ross (PSYCHOLOGIST) |
| Authorized Official Contact | 2604364100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinical & Forensic Psychological Services Of Indiana, P.c. 4630 W Jefferson Blvd Suite 5 Fort Wayne IN 46804-6856 Ph: (260) 436-4100 | Clinical & Forensic Psychological Services Of Indiana, P.c. 4630 W Jefferson Blvd Suite 5 Fort Wayne IN 46804-6856 Ph: (260) 436-4100 |
| NPI Number | 1821208000 |
|---|---|
| Provider Enumeration Date | 05/23/2007 |
| Last Update Date | 03/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821208000 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 20040536A (Indiana) | Primary |
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