Individual
KATIE MARIE ROUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A, CCC-SLP
Contact information
Practice address
610 MAGNOLIA RIDGE ROAD, BOUTTE, LA 70039
(504) 250-3764
Mailing address
610 MAGNOLIA RIDGE RD, BOUTTE, LA 70039-3223
(504) 250-3764
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5510
LA
Other
Enumeration date
11/23/2011
Last updated
11/23/2011
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