Individual
MS. ANNE ROUSSEAU DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., LMFT
Contact information
Practice address
190 MAPLE HILL ROAD, GLENCOE, IL 60022
(847) 835-3100
(847) 835-1684
Mailing address
190 MAPLE HILL ROAD, GLENCOE, IL 60022
(847) 835-3100
(847) 835-1684
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
166.000554
IL
106H00000X
Marriage & Family Therapist
166000554
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001632625
BCBS
IL
Enumeration date
11/29/2006
Last updated
12/17/2009
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