Doctor Name: | MR. JEFFREY M ROSS |
NPI Number: | 1013038645 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | 179822 |
Business Practice Address: | 9055 Manion Dr Beaumont, TX - 777063856 |
Business Phone Number: | 4098660976 |
Business Fax Number: | 4098668190 |
Mailing Address: | 9055 Manion Dr, BEAUMONT |
State: | TX |
Postal Code: | 777063856 |
Phone Number: | 4098660976 |
Fax Number: | 4098668190 |
NPI Enumeration Date: | 04/02/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 179822 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |