Basic Information
| Provider Information | |||||||||
| NPI: | 1881943785 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROMERO | ||||||||
| FirstName: | DEBBIE | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | LBSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3695 HOT SPRINGS BLVD | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NM | ||||||||
| PostalCode: | 87701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5054542306 | ||||||||
| FaxNumber: | 5054542172 | ||||||||
| Practice Location | |||||||||
| Address1: | 700 FRIEDMAN AVENUE | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NM | ||||||||
| PostalCode: | 87701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5054542306 | ||||||||
| FaxNumber: | 5054542172 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/06/2012 | ||||||||
| LastUpdateDate: | 01/04/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | N | Behavioral Health & Social Service Providers | Counselor | 1041C0700X | B08066 | NM | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.