Provider Demographics
NPI:1902502313
Name:ROMANO, ELIZABETH (CSP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:ROMANO
Suffix:
Gender:F
Credentials:CSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9841 WASHINGTONIAN BLVD STE 100-1065
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-5389
Mailing Address - Country:US
Mailing Address - Phone:470-368-2049
Mailing Address - Fax:833-630-0540
Practice Address - Street 1:3300 DEVONSHIRE ST
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-3175
Practice Address - Country:US
Practice Address - Phone:470-368-2049
Practice Address - Fax:833-630-0540
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSP-29927171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator