Provider Demographics
NPI:1659722759
Name:ROMANO, MARIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:ROMANO
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 1:6850 MISSION GORGE RD APT 2349
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92120-2499
Mailing Address - Country:US
Mailing Address - Phone:619-846-3936
Mailing Address - Fax:
Practice Address - Street 1:6850 MISSION GORGE RD APT 2349
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92120-2499
Practice Address - Country:US
Practice Address - Phone:619-846-3936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-29
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19221235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist