Organization
ADVANCED NEUROTHERAPY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOLENE ROSS PH.D. (LICENSED PSYCHOLOGIST/DIRECTOR)
(781) 444-9115
Entity
Organization
Contact information
Practice address
140 BRISTOL RD, WELLESLEY, MA 02481-2730
(781) 444-9115
Mailing address
10436 PARK TREE PL, GLEN ALLEN, VA 23060-4487
(781) 444-9115
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
3976
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
722869
TUFTS COMMERCIAL
MA
01
—
W03950
BCBS PROVIDER #
MA
Enumeration date
07/20/2006
Last updated
06/15/2023
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