Provider Demographics
NPI:1982750329
Name:ROMERO, CONNIE (MSW)
Entity Type:Individual
Prefix:MS
First Name:CONNIE
Middle Name:
Last Name:ROMERO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4985 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-1802
Mailing Address - Country:US
Mailing Address - Phone:505-424-9789
Mailing Address - Fax:505-424-9792
Practice Address - Street 1:4985 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-1802
Practice Address - Country:US
Practice Address - Phone:505-424-9789
Practice Address - Fax:505-424-9792
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMM24871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical