Individual
MRS. MIKELLE MONIQUE ROMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1530 5TH AVE, SUITE E, SAN RAFAEL, CA 94901-1816
(415) 457-7745
(415) 453-9685
Mailing address
1530 5TH AVE, SUITE E, SAN RAFAEL, CA 94901-1816
(415) 457-7745
(415) 453-9685
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT5997
CA
Other
Enumeration date
10/15/2009
Last updated
10/15/2009
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