Provider Demographics
NPI:1518006246
Name:ROSS, DONNA ALTERMAN (PSYD)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:ALTERMAN
Last Name:ROSS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:
Other - Last Name:ALTERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4501 CONNECTICUT AVE NW
Mailing Address - Street 2:SUITE 107
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-3710
Mailing Address - Country:US
Mailing Address - Phone:202-249-8055
Mailing Address - Fax:202-249-8054
Practice Address - Street 1:4501 CONNECTICUT AVE NW
Practice Address - Street 2:SUITE 107
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-3710
Practice Address - Country:US
Practice Address - Phone:202-249-8055
Practice Address - Fax:202-249-8054
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD3019103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
490624Medicare ID - Type UnspecifiedMEDICARE