Provider Demographics
NPI:1932260494
Name:ROMANO, CHRISTINA (MED)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:
Last Name:ROMANO
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7931 S CAMINO MIRLO
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85747-9342
Mailing Address - Country:US
Mailing Address - Phone:520-647-3172
Mailing Address - Fax:520-647-0086
Practice Address - Street 1:2550 E FORT LOWELL RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-1514
Practice Address - Country:US
Practice Address - Phone:520-390-2839
Practice Address - Fax:520-647-0086
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLISAC-11610101YA0400X
AZLPC-10326101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ784844Medicaid