Healthcare Provider Details

I. General information

NPI: 1811438328
Provider Name (Legal Business Name): ELISABETH ROMINES LATINO PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELISABETH ANNA ROMINES

II. Dates (important events)

Enumeration Date: 03/16/2017
Last Update Date: 03/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 CALHOUN ST SUITE 200
CINCINNATI OH
45219-1528
US

IV. Provider business mailing address

MAIL LOCATION 0034
CINCINNATI OH
45221-0034
US

V. Phone/Fax

Practice location:
  • Phone: 513-556-0648
  • Fax: 513-556-2302
Mailing address:
  • Phone: 513-556-0648
  • Fax: 513-556-2302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number7537
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: