Provider Demographics
NPI:1932457389
Name:ROMERO, DAVID REUEL (LPC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:REUEL
Last Name:ROMERO
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4451 E GLEN CREEK PL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-1173
Mailing Address - Country:US
Mailing Address - Phone:520-240-8028
Mailing Address - Fax:
Practice Address - Street 1:4451 E GLEN CREEK PL
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-1173
Practice Address - Country:US
Practice Address - Phone:520-240-8028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-0678101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional