Healthcare Provider Details

I. General information

NPI: 1750119871
Provider Name (Legal Business Name): HAYDEE ROMERO LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2024
Last Update Date: 07/22/2024
Certification Date: 07/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2538 CAMINO ENTRADA STE 300
SANTA FE NM
87507-4927
US

IV. Provider business mailing address

PO BOX 33286
SANTA FE NM
87594-3286
US

V. Phone/Fax

Practice location:
  • Phone: 505-424-1239
  • Fax:
Mailing address:
  • Phone: 505-424-1239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number22011
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: