Individual
MS. DENITA MARIE DEROUSELLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
251 REES ST,, BREAUX BRIDGE, LA 70517
(337) 442-6823
(337) 442-6825
Mailing address
913 S COLLEGE RD STE 105, LAFAYETTE, LA 70503-3061
(337) 534-8433
(337) 534-8428
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/13/2017
Last updated
03/28/2019
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