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General NPI Number Information
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NPI Number | 1902502313
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Entity Type | Individual
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Provider Name | ELIZABETH ROMANO CSP
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Gender | Female
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Dates
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Enumeration Date | 02/07/2023
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Last Update Date | 02/07/2023
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Provider Practice Location Address
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Address Line | 3300 DEVONSHIRE ST
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City | DOUGLASVILLE
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State | GA
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Zip | 30135-3175
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Country | US
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Telephone | 470-368-2049
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Fax | 833-630-0540
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Provider Business Mailing Address
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Address Line | 9841 WASHINGTONIAN BLVD STE 100-1065
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City | GAITHERSBURG
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State | MD
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Zip | 20878-5389
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Country | US
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Telephone | 470-368-2049
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Fax | 833-630-0540
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | CSP-29927
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License Number State | GA
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