Healthcare Provider Details

I. General information

NPI: 1073458048
Provider Name (Legal Business Name): REIES ROMERO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 10TH ST W UNIT 1708
SAINT PAUL MN
55102-5016
US

IV. Provider business mailing address

26 10TH ST W UNIT 1708
SAINT PAUL MN
55102-5016
US

V. Phone/Fax

Practice location:
  • Phone: 651-270-7592
  • Fax:
Mailing address:
  • Phone: 651-270-7592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: