Provider Demographics
NPI:1558738518
Name:ROMANOW, HEATHER DANIELLE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:DANIELLE
Last Name:ROMANOW
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3434 LAURENS RD APT 415
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-5278
Mailing Address - Country:US
Mailing Address - Phone:814-659-6017
Mailing Address - Fax:
Practice Address - Street 1:THE ADVANCED INSTITUTE FOR DEVELOPMENT AND LEARNING
Practice Address - Street 2:545 VERDAE BLVD
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607
Practice Address - Country:US
Practice Address - Phone:864-520-8910
Practice Address - Fax:864-520-8912
Is Sole Proprietor?:No
Enumeration Date:2015-08-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4624235Z00000X
PASL012530235Z00000X
SC6184235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist