Provider Demographics
NPI:1225173685
Name:FERRO, JAMES ANTHONY (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ANTHONY
Last Name:FERRO
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:PO BOX 325
Mailing Address - Street 2:
Mailing Address - City:MOAB
Mailing Address - State:UT
Mailing Address - Zip Code:84532-0325
Mailing Address - Country:US
Mailing Address - Phone:435-260-1138
Mailing Address - Fax:435-259-5410
Practice Address - Street 1:76 S MAIN ST
Practice Address - Street 2:STE. # 6
Practice Address - City:MOAB
Practice Address - State:UT
Practice Address - Zip Code:84532-2567
Practice Address - Country:US
Practice Address - Phone:435-260-1138
Practice Address - Fax:435-259-5410
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT114051-2501103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTS30633Medicare UPIN