Individual
BLAKE ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3080 VALMONT RD STE 220, BOULDER, CO 80301-2152
(720) 772-7334
Mailing address
3203 GRAND TETON PL, FORT COLLINS, CO 80525-9083
(423) 847-7734
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/29/2018
Last updated
03/29/2018
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