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DR. ANDRE ROUSSEAU PSY.D.

Clinical Neuropsychologist

Show Low, Arizona

Provider NPI: 1316936362

Provider Information:
DR. ANDRE  ROUSSEAU PSY.D.
Gender: M
Sole Proprietor


Practice Location:
2707 S WHITE MOUNTAIN RD SUITE G SHOW LOW, AZ 85901 US
Tel: 928-532-1200  Fax: 928-532-1645

Business Mailing Address:
1350 W SIERRA BUENA CT  SHOW LOW, AZ 85901 US
Tel: 928-532-1200  Fax: 928-532-1645

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
AZ1298

Other Provider Identifiers:

IssuerNumberStateType
R21188AZ02
487753AZ05
28430AZ04
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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