Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | PA | |
N | 101YM0800X | Mental Health Counselor | ||
N | 101YP2500X | Professional Counselor | ||
N | 103K00000X | Behavior Analyst | ||
N | 103TM1800X | Intellectual & Developmental Disabilities | ||
N | 1041C0700X | Clinical Social Worker | ||
N | 106E00000X | Assistant Behavior Analyst | ||
N | 106S00000X | Behavior Technician | ||
N | 225100000X | Physical Therapist | ||
N | 225C00000X | Rehabilitation Counselor |
NPI | 1215400106 |
---|---|
Provider Name | David Francis Ross SR. |
First Address | Philadelphia, PA 19120-2211 |
Second Address | Philadelphia, PA 19120-2211 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2019 |
Last Update Date | 03/01/2019 |