Provider Demographics
NPI:1124632054
Name:ROUSSEAU, TAYLER ELIZABETH
Entity type:Individual
Prefix:
First Name:TAYLER
Middle Name:ELIZABETH
Last Name:ROUSSEAU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4020 PARKLAND ESTATES CT
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-4956
Mailing Address - Country:US
Mailing Address - Phone:308-660-2576
Mailing Address - Fax:
Practice Address - Street 1:700 E 3RD ST
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-4212
Practice Address - Country:US
Practice Address - Phone:308-535-7136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-08
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist