Provider Demographics
NPI:1194429654
Name:ROMAN, ANA MARIE (EDD, MSW)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:MARIE
Last Name:ROMAN
Suffix:
Gender:F
Credentials:EDD, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE NELSON L. MILLS BENABE
Mailing Address - Street 2:CASA EA-2, URBANIZACION BRISAS DEL MAR
Mailing Address - City:LUQUILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00773-0000
Mailing Address - Country:US
Mailing Address - Phone:787-556-5326
Mailing Address - Fax:
Practice Address - Street 1:CALLE NELSON L. MILLS BENABE
Practice Address - Street 2:CASA EA-2, URBANIZACION BRISAS DEL MAR
Practice Address - City:LUQUILLO
Practice Address - State:PR
Practice Address - Zip Code:00773-0000
Practice Address - Country:US
Practice Address - Phone:787-556-5326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR149541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical