Provider Demographics
NPI:1508395104
Name:ROMERO CORONADO, YVETTE SONIA (LCSW)
Entity Type:Individual
Prefix:
First Name:YVETTE
Middle Name:SONIA
Last Name:ROMERO CORONADO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2731 W REDWICK CT
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84129-5901
Mailing Address - Country:US
Mailing Address - Phone:801-865-4076
Mailing Address - Fax:
Practice Address - Street 1:3763 S SECORD ST
Practice Address - Street 2:
Practice Address - City:SOUTH SALT LAKE
Practice Address - State:UT
Practice Address - Zip Code:84115-4771
Practice Address - Country:US
Practice Address - Phone:801-935-8911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-07
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8287050-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical