# MR. ROSS LOWELL MAYBERRY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1609948678
- **Gender:** Man
- **Credential:** PH.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | WAPSY1297 | WA | Yes |
| 103TC1900X | Counseling Psychologist | PSY 1297 | WA | — |

## Other

- **Enumeration date:** 11/15/2006
- **Last updated:** 01/25/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 91-1985428 | TAX ID \# | — |