Provider Demographics
NPI:1194020552
Name:ROMEO WELLS, LORI F (MS, CCC-S)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:F
Last Name:ROMEO WELLS
Suffix:
Gender:F
Credentials:MS, CCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 ALVA DR
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-4703
Mailing Address - Country:US
Mailing Address - Phone:518-785-9100
Mailing Address - Fax:
Practice Address - Street 1:7 ALVA DR
Practice Address - Street 2:
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-4703
Practice Address - Country:US
Practice Address - Phone:518-785-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-17
Last Update Date:2011-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0054311-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist