Provider Demographics
NPI:1427008895
Name:ROSS, DANA (PHD)
Entity Type:Individual
Prefix:
First Name:DANA
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 1:2 RIVERCHASE RIDGE
Mailing Address - Street 2:GRAYSON & ASSOCIATES PC SUITE 100
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35244
Mailing Address - Country:US
Mailing Address - Phone:205-444-0420
Mailing Address - Fax:205-403-0747
Practice Address - Street 1:2 RIVERCHASE RIDGE
Practice Address - Street 2:GRAYSON & ASSOCIATES PC SUITE 100
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35244
Practice Address - Country:US
Practice Address - Phone:205-444-0420
Practice Address - Fax:205-403-0747
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1224103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P82064Medicare UPIN