Provider Demographics
NPI:1326431933
Name:ROSS, SARAH (PHD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
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 1:4200 SPEEDWAY
Mailing Address - Street 2:APT. 5
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78751-3770
Mailing Address - Country:US
Mailing Address - Phone:336-391-5237
Mailing Address - Fax:
Practice Address - Street 1:4200 SPEEDWAY
Practice Address - Street 2:APT. 5
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78751-3770
Practice Address - Country:US
Practice Address - Phone:336-391-5237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-07
Last Update Date:2015-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36501103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist