Organization
STACI R ROSS PHD INC
Active
Organization
STACI R ROSS PHD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACI R ROSS PHD INC (OWNER)
(702) 382-1960
Entity
Organization
Contact information
Practice address
716 S 6TH ST, LAS VEGAS, NV 89101-6922
(702) 382-1960
(702) 382-4993
Mailing address
716 S 6TH ST, LAS VEGAS, NV 89101-6922
(702) 382-1960
(702) 382-4993
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PY0406
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00-2602024
—
NV
Enumeration date
11/14/2013
Last updated
11/14/2013
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