Individual
MARIO ROMERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
707 BROADWAY BLVD NE STE 300, ALBUQUERQUE, NM 87102
(505) 345-8471
Mailing address
707 BROADWAY BLVD NE STE 300, ALBUQUERQUE, NM 87102-2365
(505) 345-8471
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
NM
Enumeration date
03/06/2017
Last updated
07/11/2018
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