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General NPI Number Information
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NPI Number | 1346799533
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Entity Type | Individual
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Provider Name | DANA DELCONTE ROMAN MA, CCC/SLP
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Gender | Female
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Dates
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Enumeration Date | 09/28/2016
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Last Update Date | 09/28/2016
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Provider Practice Location Address
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Address Line | 111 SAGO LN
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City | MOORESVILLE
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State | NC
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Zip | 28117-4369
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Country | US
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Telephone | 704-293-6552
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Fax | 704-662-3304
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Provider Business Mailing Address
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Address Line | 15710 SAGEFIELD DR
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-2221
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Country | US
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Telephone | 704-728-3947
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 8513
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License Number State | NC
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