Organization Name: | STACI R ROSS PHD INC |
NPI Number: | 1801226626 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | STACI R ROSS (OWNER) |
Mailing Address: | 716 S 6th St Las Vegas |
State: | NV US |
Postal Code: | 891016922 |
Phone Number: | 7023821960 |
Fax Number: | 7023824993 |
NPI Enumeration Date: | 11/14/2013 |
NPI Last Update Date: | 11/14/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | PY0406 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NV |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Clinical Neuropsychologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |