Provider Demographics
NPI:1710548128
Name:ROMANO, TRISH DEANA (SLPA)
Entity Type:Individual
Prefix:
First Name:TRISH
Middle Name:DEANA
Last Name:ROMANO
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:TRISH
Other - Middle Name:DEANA
Other - Last Name:JACKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17927 N PARKVIEW PL APT 5204
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-2411
Mailing Address - Country:US
Mailing Address - Phone:602-692-8131
Mailing Address - Fax:
Practice Address - Street 1:17927 N PARKVIEW PL APT 52045204
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-3441
Practice Address - Country:US
Practice Address - Phone:602-692-8131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-26
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA118212355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant