Individual
JEREMY ROUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
333 FOUNDRY ST, NEW MARTINSVILLE, WV 26155-1142
(304) 455-2441
Mailing address
333 FOUNDRY ST, NEW MARTINSVILLE, WV 26155-1142
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
98704712
WV
Other
Enumeration date
01/17/2012
Last updated
01/17/2012
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