Doctor Name: | MR. DAVID HENRY ROUSH |
NPI Number: | 1366593063 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PSYD |
License Number: | 5807 |
Business Practice Address: | 2378 National Rd Fairborn, OH - 453242009 |
Business Phone Number: | 9378797996 |
Business Fax Number: | 9378797959 |
Mailing Address: | 2378 National Rd, FAIRBORN |
State: | OH |
Postal Code: | 453242009 |
Phone Number: | 9378797996 |
Fax Number: | 9378797959 |
NPI Enumeration Date: | 01/16/2007 |
NPI Last Update Date: | 05/24/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 5807 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |