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NPI Code Detail

MEDICARE: MRS. BIANCA ROMERO KOOI LCSWA

MEDICARE: MRS. BIANCA ROMERO KOOI LCSWA
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
11041C0700XClinical Social WorkerP021043NC

General Provider Information

NPI Number : 1245469683
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BIANCA ROMERO KOOI LCSWA
Provider Business Mailing Address
First Line : 12662 CARDINAL WOODS DR
Second Line :
City : PINEVILLE
State : NC
Zip : 28134-9115
Country : US
Telephone Number : 404-790-8539
Fax Number :
Provider Business Practice Location Address
First Line : 280 EXECUTIVE PARK DR STE 100
Second Line :
City : CONCORD
State : NC
Zip : 28025-1838
Country : US
Telephone Number : 404-790-8539
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2009
Last Update Date : 08/06/2024

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