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NPI Code Detail

MEDICARE: KEVIN ROSS AA

MEDICARE: KEVIN ROSS AA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor

General Provider Information

NPI Number : 1760791420
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN ROSS AA
Provider Business Mailing Address
First Line : 545 WESTMINSTER ST
Second Line :
City : FITCHBURG
State : MA
Zip : 01420-4766
Country : US
Telephone Number : 978-345-0685
Fax Number :
Provider Business Practice Location Address
First Line : 545 WESTMINSTER ST
Second Line :
City : FITCHBURG
State : MA
Zip : 01420-4766
Country : US
Telephone Number : 978-345-0685
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2010
Last Update Date : 06/23/2022

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Directions to “ KEVIN ROSS AA” Practice Location

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