Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 49438 | CA |
NPI | 1003014119 |
---|---|
Provider Name | Cheryl Leigh Rouse |
First Address | Santa Clara, CA 95050-4333 |
Second Address | Santa Clara, CA 95050-4333 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2007 |
Last Update Date | 10/07/2007 |