Individual
MRS. TINA ROMERO FAHRENBROOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
1900 FLATEN AVE, GERING, NE 69341-1850
(308) 436-5555
Mailing address
1600 BEVERLY BLVD, GERING, NE 69341-1914
(308) 436-5555
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2016003984
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
23520000X
—
NE
Enumeration date
11/21/2016
Last updated
11/21/2016
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