Provider Demographics
NPI:1578353140
Name:ROMO, CAROL (MS CCC SLP)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:ROMO
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 N BEL AIRE DR
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91501-1208
Mailing Address - Country:US
Mailing Address - Phone:818-825-5291
Mailing Address - Fax:
Practice Address - Street 1:912 N BEL AIRE DR
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91501-1208
Practice Address - Country:US
Practice Address - Phone:818-825-5291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20553235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist