Healthcare Provider Details

I. General information

NPI: 1154547396
Provider Name (Legal Business Name): JOAN ROMIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1316 APACHE AVE
SANTA FE NM
87505-3212
US

IV. Provider business mailing address

1954 OSAGE DR
SANTA FE NM
87505-3330
US

V. Phone/Fax

Practice location:
  • Phone: 505-438-0035
  • Fax: 505-438-0051
Mailing address:
  • Phone: 505-983-1985
  • Fax: 505-983-1985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: