Provider Demographics
NPI:1073741013
Name:ROSS, TERRANCE (PHD)
Entity Type:Individual
Prefix:DR
First Name:TERRANCE
Middle Name:
Last Name:ROSS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 UNIVERSITY AVE W
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-4746
Mailing Address - Country:US
Mailing Address - Phone:612-659-0359
Mailing Address - Fax:612-645-1688
Practice Address - Street 1:1010 UNIVERSITY AVE W
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-4746
Practice Address - Country:US
Practice Address - Phone:612-659-0359
Practice Address - Fax:612-645-1688
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-29
Last Update Date:2009-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor