Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 3990 | CO |
N | 103T00000X | Psychologist | 3990 | CO |
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 1448 | NM |
NPI | 1104015858 |
---|---|
Provider Name | Alexandra Kathleen Romero |
First Address | Santa Fe, NM 87505-6110 |
Second Address | Santa Fe, NM 87501-6530 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2007 |
Last Update Date | 07/02/2017 |