Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | SW13105 | FL |
NPI | 1003150988 |
---|---|
Provider Name | Nicole Romans |
First Address | Port St Lucie, FL 34952-4300 |
Second Address | Port St Lucie, FL 34952-4300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2012 |
Last Update Date | 26/10/2015 |