Provider Demographics
NPI:1346799533
Name:ROMAN, DANA DELCONTE (MA, CCC/SLP)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:DELCONTE
Last Name:ROMAN
Suffix:
Gender:F
Credentials:MA, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15710 SAGEFIELD DR
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-2221
Mailing Address - Country:US
Mailing Address - Phone:704-728-3947
Mailing Address - Fax:
Practice Address - Street 1:111 SAGO LN
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-4369
Practice Address - Country:US
Practice Address - Phone:704-293-6552
Practice Address - Fax:704-662-3304
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-28
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8513235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist