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General NPI Number Information
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NPI Number | 1043740103
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Entity Type | Individual
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Provider Name | REBECCA K. ROMANO LPC, NCC
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Gender | Female
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Dates
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Enumeration Date | 06/12/2017
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Last Update Date | 10/23/2018
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Provider Practice Location Address
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Address Line | 402 VALLEY RD STE I
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City | CANON CITY
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State | CO
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Zip | 81212-4176
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Country | US
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Telephone | 719-371-2767
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 62
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City | CANON CITY
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State | CO
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Zip | 81215-0062
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Country | US
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Telephone | 719-371-2767
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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License Number | 449
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 449
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License Number State | CO
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