Doctor Name: | RAQUEL ROMAN |
NPI Number: | 1992177455 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA,BA |
License Number: | |
Business Practice Address: | 54 Pine St Waterbury Clinical Services Waterbury, CT - 067102169 |
Business Phone Number: | 2037567287 |
Business Fax Number: | 2035960722 |
Mailing Address: | 141 E Main St, 4th Floor Administration WATERBURY |
State: | CT |
Postal Code: | 067022310 |
Phone Number: | 2035749000 |
Fax Number: | 2035749006 |
NPI Enumeration Date: | 10/23/2015 |
NPI Last Update Date: | 10/23/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |