Provider Demographics
NPI:1417528431
Name:ROMERO, DENISE PATRICIA (RBT)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:PATRICIA
Last Name:ROMERO
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 CARRIEBROOKE DR
Mailing Address - Street 2:
Mailing Address - City:STEPHENS CITY
Mailing Address - State:VA
Mailing Address - Zip Code:22655-6000
Mailing Address - Country:US
Mailing Address - Phone:540-486-4653
Mailing Address - Fax:
Practice Address - Street 1:130 CARRIEBROOKE DR
Practice Address - Street 2:
Practice Address - City:STEPHENS CITY
Practice Address - State:VA
Practice Address - Zip Code:22655-6000
Practice Address - Country:US
Practice Address - Phone:540-486-4653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-09
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VABACB326490106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
03151990OtherN/A