Provider Demographics
NPI:1649679739
Name:ROUSSI, EMILY (DPT)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:
Last Name:ROUSSI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MS
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:VELAZQUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:271 PARK ST
Mailing Address - Street 2:
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-3311
Mailing Address - Country:US
Mailing Address - Phone:413-785-1153
Mailing Address - Fax:
Practice Address - Street 1:271 PARK ST
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-3311
Practice Address - Country:US
Practice Address - Phone:413-785-1153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-14
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21334225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist