Glenna Smith Rousseau, PH.D.

Individual provider Active NPI Clinical Psychologist · White River Junction, VT

NPI 1841505286 · NPPES record last updated Oct 4, 2010

Key facts

NPI
1841505286
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
50 856 (MS)
Practice address
Vamc 116a
215 N. Main St
White River Junction, VT 05009-0001
Phone
(802) 295-9363
NPI assigned
Aug 10, 2010
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
50 856MSMDClinical Psychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 50 856 MS Yes

Addresses

Primary practice location

Vamc 116a
215 N. Main St
White River Junction, VT 05009-0001

Mailing address

21 Hazen St
White River Junction, VT 05001-8141
Phone (334) 329-9686

Other providers in White River Junction, VT

All providers in White River Junction, VT · Clinical Psychologist in Vermont

Sources for this page

Verify at the official NPI Registry.