Provider Demographics
NPI:1790294031
Name:ROSS, DONITRA (PSYD)
Entity Type:Individual
Prefix:
First Name:DONITRA
Middle Name:
Last Name:ROSS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8750 GEORGIA AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3603
Mailing Address - Country:US
Mailing Address - Phone:240-289-3067
Mailing Address - Fax:
Practice Address - Street 1:3231 SUPERIOR LN STE A6
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-1939
Practice Address - Country:US
Practice Address - Phone:301-464-5129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-28
Last Update Date:2017-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist