Provider Demographics
NPI:1902438013
Name:ROSS, ELLEN (OTR)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:
Last Name:ROSS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 KIMBERLY DR
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:MA
Mailing Address - Zip Code:01226-2038
Mailing Address - Country:US
Mailing Address - Phone:413-329-8236
Mailing Address - Fax:
Practice Address - Street 1:24 PARK ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-4037
Practice Address - Country:US
Practice Address - Phone:413-499-4991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-06
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty