Individual
MAXWELL ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
512 5TH AVE APT 22, ASBURY PARK, NJ 07712-5442
(908) 770-4660
Mailing address
512 5TH AVE APT 22, ASBURY PARK, NJ 07712-5442
(908) 770-4660
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/29/2018
Last updated
05/29/2018
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