Individual
CHARLES ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2115 W PARK DR, LORAIN, OH 44053-1138
(440) 989-4922
(440) 282-4779
Mailing address
2115 W PARK DR, LORAIN, OH 44053-1138
(440) 989-4922
(440) 282-4779
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2893
OH
Other
Enumeration date
07/13/2015
Last updated
07/13/2015
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