Provider Demographics
NPI:1417451626
Name:MIAH, ROMANA CHRISTINE VILLAGOMEZ (RBT)
Entity type:Individual
Prefix:
First Name:ROMANA CHRISTINE
Middle Name:VILLAGOMEZ
Last Name:MIAH
Suffix:
Gender:
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6200 N DURANGO DR STE 110
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-3939
Mailing Address - Country:US
Mailing Address - Phone:702-577-2606
Mailing Address - Fax:702-710-6023
Practice Address - Street 1:6200 N DURANGO DR STE 110
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-3939
Practice Address - Country:US
Practice Address - Phone:702-557-7260
Practice Address - Fax:702-710-6023
Is Sole Proprietor?:No
Enumeration Date:2018-03-21
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRBT19-85752106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty