Healthcare Provider Details
I. General information
NPI: 1760671606
Provider Name (Legal Business Name): EMILY ROUGIER PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/16/2007
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14TH MEDICAL GROUP, COLUMBUS MILITARY MEDICAL GROUP 201 INDEPENDENCE DRIVE, BLDG 1100,
COLUMBUS AFB MS
39710-5300
US
IV. Provider business mailing address
14TH MEDICAL GROUP, COLUMBUS MILITARY MEDICAL GROUP 201 INDEPENDENCE DRIVE, BLDG 1100
COLUMBUS AFB MS
39710-5300
US
V. Phone/Fax
- Phone: 662-434-2239
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | 6840 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: