Individual
JENNIFER ROUSSEAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
2850 N 24TH ST, PHOENIX, AZ 85008-1004
(602) 266-5976
(602) 274-8952
Mailing address
2850 N 24TH ST, PHOENIX, AZ 85008-1004
(602) 266-5976
(602) 274-8952
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP1551
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
588642
—
AZ
01
—
AZ0140920
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
02/27/2007
Last updated
01/05/2010
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