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NPI 1194190694

NPI 1194190694 : BERNADETTE ROUMBOS LPC, RD : TUCSON, AZ

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General NPI Number Information
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    NPI Number           |    1194190694
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    Entity Type          |    Individual 
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    Provider Name        |    BERNADETTE ROUMBOS LPC, RD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/09/2015
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    Last Update Date     |    07/06/2026
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Provider Practice Location Address
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    Address Line         |    120 S HOUGHTON RD STE 138-106 
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    City                 |    TUCSON
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    State                |    AZ
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    Zip                  |    85748-6731
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    Country              |    US
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    Telephone            |    602-644-1142
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    120 S HOUGHTON RD STE 138-106 
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    City                 |    TUCSON
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    State                |    AZ
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    Zip                  |    85748-6731
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    Country              |    US
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    Telephone            |    602-644-1142
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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        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    LPC18186
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    License Number State |    AZ
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Taxonomy #2
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    Taxonomy Code        |    133V00000X
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    Taxonomy Name        |    Registered Dietitian
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    License Number       |    874789
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    License Number State |    AZ
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