Provider Demographics
NPI:1992950331
Name:ROSS, DEBORA TAYLOR (LMFT)
Entity type:Individual
Prefix:MS
First Name:DEBORA
Middle Name:TAYLOR
Last Name:ROSS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 COLORADO AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-2102
Mailing Address - Country:US
Mailing Address - Phone:954-445-0659
Mailing Address - Fax:
Practice Address - Street 1:912 GRANT PL
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-7117
Practice Address - Country:US
Practice Address - Phone:954-445-0659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-26
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO858106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist