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Individual

CATHY W ROUSSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
130 FISHER RD, SUITE 3, BERLIN, VT 05602-9516
(802) 225-5400
(802) 225-5401
Mailing address
PO BOX 547, CENTRAL VERMONT MEDICAL CENTER - FINANCE DEPT, BARRE, VT 05641-0547
(802) 225-5400
(802) 225-5401

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1618
MA
1041C0700X
Clinical Social Worker
Primary
089-0001020
VT
1041C0700X
Clinical Social Worker
1030802
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1016766
VT
Enumeration date
04/19/2007
Last updated
12/04/2014
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