Individual
DR. GLENNA SMITH ROUSSEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
VAMC 116A, 215 N. MAIN ST, WHITE RIVER JUNCTION, VT 05009-0001
(802) 295-9363
Mailing address
21 HAZEN ST, WHITE RIVER JUNCTION, VT 05001-8141
(334) 329-9686
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
50 856
MS
Other
Enumeration date
08/10/2010
Last updated
10/04/2010
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