Provider Demographics
NPI:1467793349
Name:ROMERO, LAUREEN (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LAUREEN
Middle Name:
Last Name:ROMERO
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3752 FAIRWAY PARK DR APT 201
Mailing Address - Street 2:#201
Mailing Address - City:COPLEY
Mailing Address - State:OH
Mailing Address - Zip Code:44321-3107
Mailing Address - Country:US
Mailing Address - Phone:510-827-6146
Mailing Address - Fax:
Practice Address - Street 1:3752 FAIRWAY PARK DR APT 201
Practice Address - Street 2:#201
Practice Address - City:COPLEY
Practice Address - State:OH
Practice Address - Zip Code:44321-3107
Practice Address - Country:US
Practice Address - Phone:510-827-6146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-03
Last Update Date:2013-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP16530235Z00000X
OHSP10475235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0000OtherNONE