Provider Demographics
NPI:1609958008
Name:ROOS, PATRICIA ELIZABETH (PHD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ELIZABETH
Last Name:ROOS
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 1:610 JONES FERRY RD STE 208
Mailing Address - Street 2:
Mailing Address - City:CARRBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27510-6113
Mailing Address - Country:US
Mailing Address - Phone:919-338-2928
Mailing Address - Fax:919-442-1105
Practice Address - Street 1:610 JONES FERRY RD STE 208
Practice Address - Street 2:
Practice Address - City:CARRBORO
Practice Address - State:NC
Practice Address - Zip Code:27510-6113
Practice Address - Country:US
Practice Address - Phone:919-338-2928
Practice Address - Fax:919-442-1105
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2598103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical