Provider Demographics
NPI:1114076361
Name:ROMP, KARIN MARIE (MFT)
Entity Type:Individual
Prefix:
First Name:KARIN
Middle Name:MARIE
Last Name:ROMP
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4444 RIVERSIDE DR
Mailing Address - Street 2:SUITE 307
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505
Mailing Address - Country:US
Mailing Address - Phone:818-843-5206
Mailing Address - Fax:818-541-1615
Practice Address - Street 1:4444 RIVERSIDE DR
Practice Address - Street 2:SUITE 307
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505
Practice Address - Country:US
Practice Address - Phone:818-843-5206
Practice Address - Fax:818-541-1615
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT29238103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist