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Individual

MRS. IDA LOUISE ROUSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2755 E DESERT INN RD, LAS VEGAS, NV 89121
(702) 461-4403
(702) 446-0087
Mailing address
153 BRIGHTON HILLS AVE, HENDERSON, NV 89002-0527
(702) 461-4403
(702) 446-0087

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
12/27/2012
Last updated
08/29/2018
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