Provider Demographics
NPI:1689967861
Name:ROULEAU, ANNE (AUD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:ROULEAU
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7845 OAKWOOD RD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-4280
Mailing Address - Country:US
Mailing Address - Phone:410-760-4327
Mailing Address - Fax:866-253-2466
Practice Address - Street 1:7845 OAKWOOD RD
Practice Address - Street 2:SUITE 303
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-4280
Practice Address - Country:US
Practice Address - Phone:410-760-4327
Practice Address - Fax:866-253-2466
Is Sole Proprietor?:No
Enumeration Date:2011-05-23
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01209231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist