Individual
DR. ANN ROUSSELLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
5770 S 1500 W, BUILDING G, SALT LAKE CITY, UT 84123-5216
(801) 313-7770
(801) 313-7771
Mailing address
85 BRYANT WOODS S, AMHERST, NY 14228-3604
(801) 313-7770
(801) 313-7771
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
7893436-2501
UT
Other
Enumeration date
03/15/2011
Last updated
10/24/2017
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