Doctor Name: | STACI ROSS |
NPI Number: | 1932298023 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | PY0406 |
Business Practice Address: | 716 S 6th St Las Vegas, NV - 891016922 |
Business Phone Number: | 7023821960 |
Business Fax Number: | |
Mailing Address: | 1969 Verbania Dr, LAS VEGAS |
State: | NV |
Postal Code: | 891342579 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 10/12/2006 |
NPI Last Update Date: | 07/08/2007 |
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. |