Organization
DR. M. ROUSSEAU, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHELLE M ROUSSEAU PSY.D. (LICENSED PSYCHOLOGIST)
(810) 956-4389
Entity
Organization
Contact information
Practice address
732 HOLLAND AVE, PORT HURON, MI 48060-1512
(810) 434-6280
Mailing address
3560 PINE GROVE AVE # 613, PORT HURON, MI 48060-1994
(810) 956-4389
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301012660
MI
Other
Enumeration date
02/21/2007
Last updated
08/22/2020
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