| Doctor Name: | FEDELINA DOLORES ROMERO PADILLA |
| NPI Number: | 1588989248 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LSAA |
| License Number: | 0098531 |
| Business Practice Address: | 903 C 5th Street Estancia, NM - 870160164 |
| Business Phone Number: | 5053842777 |
| Business Fax Number: | 5053842204 |
| Mailing Address: | Po Box 807, ESTANCIA |
| State: | NM |
| Postal Code: | 870160164 |
| Phone Number: | 5053842777 |
| Fax Number: | 5053842204 |
| NPI Enumeration Date: | 04/06/2010 |
| NPI Last Update Date: | 04/06/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 0098531 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |