Provider Demographics
NPI:1902105067
Name:ROSS, SYLVIA AN (PHD)
Entity Type:Individual
Prefix:DR
First Name:SYLVIA
Middle Name:AN
Last Name:ROSS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8285 W ARBY AVE
Mailing Address - Street 2:SUITE 165
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-2235
Mailing Address - Country:US
Mailing Address - Phone:702-496-5178
Mailing Address - Fax:888-805-1547
Practice Address - Street 1:7024 PACIFIC COAST ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-2824
Practice Address - Country:US
Practice Address - Phone:702-496-5178
Practice Address - Fax:888-805-1547
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-15
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPY0566103TC0700X
HI1203103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical