Provider Demographics
NPI:1720020530
Name:ROMINE, JOANNA LYNN (MSW)
Entity Type:Individual
Prefix:MS
First Name:JOANNA
Middle Name:LYNN
Last Name:ROMINE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 N HALL ALY
Mailing Address - Street 2:
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-7833
Mailing Address - Country:US
Mailing Address - Phone:606-886-1970
Mailing Address - Fax:
Practice Address - Street 1:5230 KY ROUTE 321
Practice Address - Street 2:SUITE 8
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-9168
Practice Address - Country:US
Practice Address - Phone:606-886-1970
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical