Healthcare Provider Details

I. General information

NPI: 1487787537
Provider Name (Legal Business Name): BRANDON P. ROMANO PSY.D., MSCP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10211 SIEGEN LN STE 2A
BATON ROUGE LA
70810-4926
US

IV. Provider business mailing address

10211 SIEGEN LN STE 2A
BATON ROUGE LA
70810-4926
US

V. Phone/Fax

Practice location:
  • Phone: 225-769-2533
  • Fax: 225-769-2441
Mailing address:
  • Phone: 225-769-2533
  • Fax: 225-769-2441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number977
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: