Healthcare Provider Details

I. General information

NPI: 1912321993
Provider Name (Legal Business Name): MRS. TAMARA ANN ROEMBKE-CROOKS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2014
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1845 GREENVILLE RD
BRISTOLVILLE OH
44402-9700
US

IV. Provider business mailing address

7372 REGAL DR
CONNEAUT OH
44030-3316
US

V. Phone/Fax

Practice location:
  • Phone: 330-889-1078
  • Fax: 330-889-2529
Mailing address:
  • Phone: 440-265-0961
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberLSP.01088
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: