Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | OT16758 | CA |
NPI | 1003325861 |
---|---|
Provider Name | Ashley Nicole Romano |
First Address | Grover Beach, CA 93433-2266 |
Second Address | Grover Beach, CA 93433-2266 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2017 |
Last Update Date | 25/09/2017 |