Individual
MRS. ELIZABETH L. ROUSSEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, MT-BC, QMHP
Contact information
Practice address
6021 SE 56TH AVE, PORTLAND, OR 97206-6874
(971) 404-5982
Mailing address
6021 SE 56TH AVE, PORTLAND, OR 97206-6874
(971) 404-5982
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
OR
225A00000X
Music Therapist
Primary
—
—
Other
Enumeration date
01/09/2008
Last updated
04/02/2008
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