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Individual
MS. MICHELE ANNE ROUSH
Active
Individual
MS. MICHELE ANNE ROUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, RASI
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
2012668
CA
103TC1900X
Counseling Psychologist
—
CA
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ92069Z
MEDICARE GROUP PTAN# SANTA CRUZ CA
CA
Enumeration date
11/05/2010
Last updated
07/11/2019
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