Provider Demographics
NPI:1962747550
Name:ROMER, DONNA JAYNE
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:JAYNE
Last Name:ROMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8552 LAS VEGAS BLVD.
Mailing Address - Street 2:UNIT 922
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123
Mailing Address - Country:US
Mailing Address - Phone:702-321-3600
Mailing Address - Fax:
Practice Address - Street 1:8255 LAS VEGAS BLVD S
Practice Address - Street 2:UNIT 922
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-1064
Practice Address - Country:US
Practice Address - Phone:702-321-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-07
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health