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General NPI Number Information
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NPI Number | 1750996229
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Entity Type | Individual
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Provider Name | KEITH C ROSS B.A., M.S.
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Gender | Male
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Dates
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Enumeration Date | 09/11/2020
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Last Update Date | 05/24/2023
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Provider Practice Location Address
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Address Line | 221 LAUREL RD STE 102
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City | VOORHEES
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State | NJ
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Zip | 08043-8301
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Country | US
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Telephone | 732-903-8686
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Fax |
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Provider Business Mailing Address
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Address Line | 75 LAKE DR
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City | FREEHOLD
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State | NJ
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Zip | 07728-1361
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Country | US
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Telephone | 732-903-8686
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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