MEDICARE: DR. MICHELLE LYNN ROMERO PSYD

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	103T00000X	Psychologist	PSY-005148	AZ

General Provider Information

NPI Number	:	1508490830
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELLE LYNN ROMERO PSYD

Provider Business Mailing Address
First Line	:	10210 N 92ND ST STE 101
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85258-4523
Country	:	US
Telephone Number	:	480-882-7460
Fax Number	:	480-391-3898

Provider Business Practice Location Address
First Line	:	10210 N 92ND ST STE 101
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85258-4523
Country	:	US
Telephone Number	:	480-882-7460
Fax Number	:	480-391-3898

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

Provider Enumeration Date	:	02/25/2020
Last Update Date	:	02/07/2023

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