Provider Demographics
NPI:1619501970
Name:REYNA ROMERO, YEIMI LIZBETH
Entity Type:Individual
Prefix:
First Name:YEIMI
Middle Name:LIZBETH
Last Name:REYNA ROMERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:573 CARRIAGE AVE SW
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-6342
Mailing Address - Country:US
Mailing Address - Phone:704-770-7940
Mailing Address - Fax:
Practice Address - Street 1:573 CARRIAGE AVE SW
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-6342
Practice Address - Country:US
Practice Address - Phone:704-770-7940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer