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NPI 1952992851

NPI 1952992851 : CHESTER DAVON ROSS MS : OCALA, FL

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General NPI Number Information
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    NPI Number           |    1952992851
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    Entity Type          |    Individual 
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    Provider Name        |    CHESTER DAVON ROSS MS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    02/02/2021
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    Last Update Date     |    02/02/2021
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Provider Practice Location Address
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    Address Line         |    226 NE SANCHEZ AVE 
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    City                 |    OCALA
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    State                |    FL
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    Zip                  |    34470-5871
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    Country              |    US
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    Telephone            |    352-843-2168
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    104 SE 13TH LN 
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    City                 |    GAINESVILLE
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    State                |    FL
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    Zip                  |    32601-8617
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    Country              |    US
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    Telephone            |    352-256-5662
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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        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    
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    License Number State |    
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