Provider Demographics
NPI:1295932382
Name:ROMANO, GRACE MARY (SIXTH YEAR EQUIV)
Entity type:Individual
Prefix:MS
First Name:GRACE MARY
Middle Name:
Last Name:ROMANO
Suffix:
Gender:F
Credentials:SIXTH YEAR EQUIV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 BRISTOL ST
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-4842
Mailing Address - Country:US
Mailing Address - Phone:203-488-6216
Mailing Address - Fax:
Practice Address - Street 1:44 BRISTOL ST
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-4842
Practice Address - Country:US
Practice Address - Phone:203-488-6216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0000021235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist