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NPI Code Detail

MEDICARE: KRISTIN ROMERO

MEDICARE: KRISTIN ROMERO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TS0200XSchool Psychologist

General Provider Information

NPI Number : 1275867731
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIN ROMERO
Provider Business Mailing Address
First Line : 344 S 4TH ST
Second Line :
City : SANTA ROSA
State : NM
Zip : 88435-2325
Country : US
Telephone Number : 575-472-3171
Fax Number :
Provider Business Practice Location Address
First Line : 717 S 3RD ST
Second Line :
City : SANTA ROSA
State : NM
Zip : 88435-2411
Country : US
Telephone Number : 575-472-3422
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2009
Last Update Date : 08/25/2020

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Directions to “ KRISTIN ROMERO ” Practice Location

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