Provider Demographics
NPI:1841541703
Name:ROMO, GLORIA I (SLPA)
Entity type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:I
Last Name:ROMO
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3802 W 16TH ST
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-4107
Mailing Address - Country:US
Mailing Address - Phone:928-210-2339
Mailing Address - Fax:928-276-3825
Practice Address - Street 1:3802 W 16TH ST
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-4107
Practice Address - Country:US
Practice Address - Phone:928-210-2339
Practice Address - Fax:928-276-3825
Is Sole Proprietor?:No
Enumeration Date:2012-10-01
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ79592355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant