Provider Demographics
NPI:1336367093
Name:ROMERO, LINDA J (LISW)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:J
Last Name:ROMERO
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:MISS
Other - First Name:LINDA
Other - Middle Name:J
Other - Last Name:LOVETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW
Mailing Address - Street 1:4601 PEPE ORTIZ RD SE
Mailing Address - Street 2:4601 PEPE ORTIZ
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-1207
Mailing Address - Country:US
Mailing Address - Phone:505-892-0220
Mailing Address - Fax:505-892-5724
Practice Address - Street 1:4601 PEPE ORTIZ RD SE
Practice Address - Street 2:4601 PEPE ORTIZ
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-1207
Practice Address - Country:US
Practice Address - Phone:505-892-0220
Practice Address - Fax:505-892-5724
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI28981041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool