Provider Demographics
NPI:1457305740
Name:ROMERO, LORI KELLY (MS)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:KELLY
Last Name:ROMERO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:LYNN
Other - Last Name:ROMERO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS
Mailing Address - Street 1:112 AL ROMERO JR RD
Mailing Address - Street 2:
Mailing Address - City:MAURICE
Mailing Address - State:LA
Mailing Address - Zip Code:70555-5053
Mailing Address - Country:US
Mailing Address - Phone:337-981-8816
Mailing Address - Fax:
Practice Address - Street 1:600 JEFFERSON ST
Practice Address - Street 2:SUITE 902
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70501-6942
Practice Address - Country:US
Practice Address - Phone:337-993-0000
Practice Address - Fax:337-354-2410
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3159101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional