Healthcare Provider Details

I. General information

NPI: 1598602856
Provider Name (Legal Business Name): PAOLA GISSEL ROMERO RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 SAINT CHARLES SQ
STERLING VA
20164-3239
US

IV. Provider business mailing address

129 SAINT CHARLES SQ
STERLING VA
20164-3239
US

V. Phone/Fax

Practice location:
  • Phone: 703-870-1247
  • Fax: 804-652-9997
Mailing address:
  • Phone: 703-870-1247
  • Fax: 804-652-9997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: