Provider Demographics
NPI:1801231121
Name:SYLVIA AN ROSS PHD LLC
Entity Type:Organization
Organization Name:SYLVIA AN ROSS PHD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:AN
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:808-938-2260
Mailing Address - Street 1:PO BOX 736
Mailing Address - Street 2:
Mailing Address - City:CAPTAIN COOK
Mailing Address - State:HI
Mailing Address - Zip Code:96704-0736
Mailing Address - Country:US
Mailing Address - Phone:808-938-2260
Mailing Address - Fax:888-805-1547
Practice Address - Street 1:81-6224 MAMALAHOA HWY
Practice Address - Street 2:B3
Practice Address - City:CAPTAIN COOK
Practice Address - State:HI
Practice Address - Zip Code:96704-8111
Practice Address - Country:US
Practice Address - Phone:808-938-2260
Practice Address - Fax:888-805-1547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-30
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1203103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty