Provider Demographics
NPI:1730661448
Name:ROMANO, KELLY A (SLP)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:A
Last Name:ROMANO
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 WINTERGREEN HILL DR
Mailing Address - Street 2:
Mailing Address - City:PAINESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44077-5327
Mailing Address - Country:US
Mailing Address - Phone:440-853-8055
Mailing Address - Fax:
Practice Address - Street 1:2181 AMBLESIDE DR
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-4645
Practice Address - Country:US
Practice Address - Phone:216-721-1234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist