Provider Demographics
NPI:1841274982
Name:ROUSSEAU, JULIE A (MS, CGC)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:A
Last Name:ROUSSEAU
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:916 UNION ST
Mailing Address - Street 2:
Mailing Address - City:ROCKLAND
Mailing Address - State:MA
Mailing Address - Zip Code:02370-1645
Mailing Address - Country:US
Mailing Address - Phone:857-939-1803
Mailing Address - Fax:
Practice Address - Street 1:99 ERIE ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-4559
Practice Address - Country:US
Practice Address - Phone:617-553-5821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS