MEDICARE: TARA ROMERO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst
2	225400000X	Rehabilitation Practitioner
3	101YP2500X	Professional Counselor	CI5555	NV

General Provider Information

NPI Number	:	1063714533
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TARA ROMERO

Provider Business Mailing Address
First Line	:	2535 W CHEYENNE AVE STE 102
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-8930
Country	:	US
Telephone Number	:	702-631-9275
Fax Number	:

Provider Business Practice Location Address
First Line	:	5652 SALT ROCK ST
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-1309
Country	:	US
Telephone Number	:	702-738-2482
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/03/2010
Last Update Date	:	05/22/2025

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Directions to “ TARA ROMERO ” Practice Location

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