Provider Demographics
NPI:1174960785
Name:ROSS, VALERIE VOGEL (PSYD)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:VOGEL
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 1:2734 FYNAMORE LN
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-6027
Mailing Address - Country:US
Mailing Address - Phone:484-288-8060
Mailing Address - Fax:
Practice Address - Street 1:2734 FYNAMORE LN
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-6027
Practice Address - Country:US
Practice Address - Phone:484-288-8060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-23
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS017388103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist