Individual
NATASHA NICOLE ROUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1171 S KGB RD, STE 700, WASILLA, AK 99654
(304) 736-4141
Mailing address
3050 W STONERIDGE CIR, WASILLA, AK 99654-0753
(304) 654-1369
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
AP00941482
WV
1041C0700X
Clinical Social Worker
Primary
1336
AK
Other
Enumeration date
06/06/2007
Last updated
01/05/2015
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