Provider Demographics
NPI:1124186648
Name:ROSS, RETHIA (PHD)
Entity Type:Individual
Prefix:MS
First Name:RETHIA
Middle Name:
Last Name:ROSS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:RETHIA
Other - Middle Name:
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DR RETHIA ROSS
Mailing Address - Street 1:216 E EXPRESSWAY 83 STE G STE F
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-6517
Mailing Address - Country:US
Mailing Address - Phone:956-785-1951
Mailing Address - Fax:956-785-1944
Practice Address - Street 1:216 E EXPRESSWAY 83 STE G STE F
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-6517
Practice Address - Country:US
Practice Address - Phone:956-785-1951
Practice Address - Fax:956-785-1944
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLPC18912101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health