Provider Demographics
NPI:1194420596
Name:ROMERO, DUJUAN L (LCDC)
Entity type:Individual
Prefix:MS
First Name:DUJUAN
Middle Name:L
Last Name:ROMERO
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4411 MERCEDES DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79703-5423
Mailing Address - Country:US
Mailing Address - Phone:432-242-1435
Mailing Address - Fax:
Practice Address - Street 1:4411 MERCEDES DR
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79703-5423
Practice Address - Country:US
Practice Address - Phone:432-242-1435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-04
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14915101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)