Provider Demographics
NPI:1124881263
Name:DEBORA ROSS THERAPY
Entity type:Organization
Organization Name:DEBORA ROSS THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORA
Authorized Official - Middle Name:TAYLOR
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:720-419-2362
Mailing Address - Street 1:PO BOX 386
Mailing Address - Street 2:
Mailing Address - City:CRESTONE
Mailing Address - State:CO
Mailing Address - Zip Code:81131-0386
Mailing Address - Country:US
Mailing Address - Phone:720-419-2362
Mailing Address - Fax:
Practice Address - Street 1:3574 ALFRESCO WAY
Practice Address - Street 2:
Practice Address - City:CRESTONE
Practice Address - State:CO
Practice Address - Zip Code:81131
Practice Address - Country:US
Practice Address - Phone:720-419-2362
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty