Individual
BETHANEE RENEE' ROUSSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5755 MARK DABLING BLVD STE 250, COLORADO SPRINGS, CO 80919-2272
(719) 966-1854
Mailing address
5755 MARK DABLING BLVD STE 250, COLORADO SPRINGS, CO 80919-2272
(719) 966-1854
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-279931
CO
Other
Enumeration date
08/31/2023
Last updated
08/31/2023
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