Provider Demographics
NPI:1083816268
Name:ROMERO, ROSSANY (MRC)
Entity Type:Individual
Prefix:
First Name:ROSSANY
Middle Name:
Last Name:ROMERO
Suffix:
Gender:F
Credentials:MRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 ASHLEY TRL
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30223-8203
Mailing Address - Country:US
Mailing Address - Phone:956-929-9566
Mailing Address - Fax:
Practice Address - Street 1:440 RALPH MCGILL BLVD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-1217
Practice Address - Country:US
Practice Address - Phone:404-418-7400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor