Provider Demographics
NPI:1639043607
Name:CHITKO, ROMA
Entity type:Individual
Prefix:
First Name:ROMA
Middle Name:
Last Name:CHITKO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5205 COMMONWEALTH CENTRE PKWY
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-2623
Mailing Address - Country:US
Mailing Address - Phone:804-977-2770
Mailing Address - Fax:
Practice Address - Street 1:5205 COMMONWEALTH CENTRE PKWY
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-2623
Practice Address - Country:US
Practice Address - Phone:804-977-2770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-02
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2204001708235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist