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General NPI Number Information
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NPI Number | 1851051874
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Entity Type | Individual
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Provider Name | COURTNEY L ROMINE MS CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 12/20/2021
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Last Update Date | 12/20/2021
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Provider Practice Location Address
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Address Line | 128TH AVE H
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City | VAN VLECK
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State | TX
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Zip | 77482
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Country | US
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Telephone | 979-318-7606
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Fax |
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Provider Business Mailing Address
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Address Line | 11583 STATE HIGHWAY 60 S
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City | BAY CITY
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State | TX
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Zip | 77414-3293
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Country | US
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Telephone | 979-241-1722
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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 | 112062
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License Number State | TX
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