Doctor Name: | BRENDA KAY ROUSSE |
NPI Number: | 1275674731 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMSW |
License Number: | 6801065423 |
Business Practice Address: | 1000 W Cedar St Standish, MI - 486589421 |
Business Phone Number: | 9898464573 |
Business Fax Number: | |
Mailing Address: | 685 Main St, Po Box 207 OMER |
State: | MI |
Postal Code: | 48749 |
Phone Number: | 9898464573 |
Fax Number: | |
NPI Enumeration Date: | 02/09/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 6801065423 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |