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NPI Code Detail

MEDICARE: ERICA HEATHER ROUSH MA

MEDICARE: ERICA HEATHER ROUSH MA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorUNLICENSED PSYCHOTHECO

General Provider Information

NPI Number : 1093869398
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERICA HEATHER ROUSH MA
Provider Business Mailing Address
First Line : 1155 MARINE ST APT 407
Second Line :
City : BOULDER
State : CO
Zip : 80302-6153
Country : US
Telephone Number : 303-523-0895
Fax Number :
Provider Business Practice Location Address
First Line : 4371 E 72ND AVE
Second Line :
City : COMMERCE CITY
State : CO
Zip : 80022-1471
Country : US
Telephone Number : 303-482-7862
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2007
Last Update Date : 07/08/2007

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Directions to “ ERICA HEATHER ROUSH MA” Practice Location

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