| Doctor Name: | JESSICA ANN ROUILLARD |
| NPI Number: | 1013252733 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | IADC |
| License Number: | 11112 |
| Business Practice Address: | 319 5th St Hudson, SD - 57034 |
| Business Phone Number: | 3202620433 |
| Business Fax Number: | |
| Mailing Address: | Po Box 343, HUDSON |
| State: | SD |
| Postal Code: | 570340343 |
| Phone Number: | 3202620433 |
| Fax Number: | |
| NPI Enumeration Date: | 12/06/2012 |
| NPI Last Update Date: | 12/06/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 11112 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |