Individual
KERI ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
428 N ASH AVE, TAHLEQUAH, OK 74464-2902
(918) 931-1477
Mailing address
428 N ASH AVE, TAHLEQUAH, OK 74464-2902
(918) 931-1477
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/10/2014
Last updated
09/10/2014
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