Provider Demographics
NPI:1093927410
Name:ROMINE, LINDA KAY (MAT,CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:KAY
Last Name:ROMINE
Suffix:
Gender:F
Credentials:MAT,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 VALHALLA CIR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-8613
Mailing Address - Country:US
Mailing Address - Phone:803-413-2803
Mailing Address - Fax:803-765-9765
Practice Address - Street 1:21 VALHALLA CIR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-8613
Practice Address - Country:US
Practice Address - Phone:803-413-2803
Practice Address - Fax:803-765-9765
Is Sole Proprietor?:No
Enumeration Date:2007-05-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3666235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist