Individual
CECIL ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
731 BIELENBERG DR STE 102-105, WOODBURY, MN 55125-1700
(612) 445-8326
(612) 445-8325
Mailing address
795 AURORA AVE, SAINT PAUL, MN 55104-4814
(904) 477-3017
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/01/2021
Last updated
11/01/2021
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