Provider Demographics
NPI:1821323551
Name:ROMANO, FAYE ELIZABETH (PSYD, MED)
Entity Type:Individual
Prefix:DR
First Name:FAYE
Middle Name:ELIZABETH
Last Name:ROMANO
Suffix:
Gender:F
Credentials:PSYD, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1133 HEATHERSTONE DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-4828
Mailing Address - Country:US
Mailing Address - Phone:540-548-4222
Mailing Address - Fax:540-548-0008
Practice Address - Street 1:1133 HEATHERSTONE DR
Practice Address - Street 2:SUITE 102
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-4828
Practice Address - Country:US
Practice Address - Phone:540-548-4222
Practice Address - Fax:540-548-0008
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-14
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004102103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA27-0425908OtherFEDERAL TAX ID NUMBER