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Organization
LJ ROUSE PLLC
Active
Organization
LJ ROUSE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAURA ROUSE LCSW (OWNER/LCSW)
(850) 960-2190
Entity
Organization
Contact information
Practice address
429 S TYNDALL PKWY, PANAMA CITY, FL 32404-6765
(850) 960-2190
(850) 769-2366
Mailing address
101 W 5TH ST, PANAMA CITY, FL 32401-2603
(850) 960-2190
(850) 769-2366
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW10901
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HT655Z
SOCIAL WORK
FL
Enumeration date
03/28/2018
Last updated
06/16/2018
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