MEDICARE: KARYN ROMO

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	101YP2500X	Professional Counselor	LPC-19332	AZ

General Provider Information

NPI Number	:	1376080473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARYN ROMO

Provider Business Mailing Address
First Line	:	10201 S 51ST ST STE 130
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85044-5226
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10201 S 51ST ST
Second Line	:	SUITE 130
City	:	PHOENIX
State	:	AZ
Zip	:	85044-5215
Country	:	US
Telephone Number	:	602-525-5783
Fax Number	:

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

Provider Enumeration Date	:	01/26/2017
Last Update Date	:	01/11/2021

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Directions to “ KARYN ROMO ” Practice Location

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