Provider Demographics
NPI:1447460027
Name:ROMAN-COLLAZO, DAMARIZ (MS SLP)
Entity type:Individual
Prefix:
First Name:DAMARIZ
Middle Name:
Last Name:ROMAN-COLLAZO
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CORDOBA PARK
Mailing Address - Street 2:400 BO TORTUGO APT. 47
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-648-4163
Mailing Address - Fax:
Practice Address - Street 1:CORDOBA PARK
Practice Address - Street 2:400 BO TORTUGO APT. 47
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-648-4163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR694235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist