| NPI | 1063250132 |
|---|---|
| Former Legal Business Name | DERREK ROSS M DIV LAC LCPC PLLC |
| Entity Type | Organization |
| Authorized Contact | DERREK ROSS Owner 406-876-3096 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Enumeration Date | 2024-07-15 |
| Last Update Date | 2026-05-07 |