Provider Demographics
NPI:1972055937
Name:ROMAN, CARMEN A
Entity type:Individual
Prefix:MS
First Name:CARMEN
Middle Name:A
Last Name:ROMAN
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:URBANIZACION LAS VEGAS H-2
Mailing Address - Street 2:
Mailing Address - City:FLORIDA
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00650
Mailing Address - Country:AX
Mailing Address - Phone:787-629-4422
Mailing Address - Fax:
Practice Address - Street 1:URBANIZACION LAS VEGAS H-2
Practice Address - Street 2:
Practice Address - City:FLORIDA
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00650
Practice Address - Country:AX
Practice Address - Phone:787-629-4422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-25
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR004080-12355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant