Provider Demographics
NPI:1073376562
Name:RAMSEY, DYLAN ALEXANDER
Entity Type:Individual
Prefix:MR
First Name:DYLAN
Middle Name:ALEXANDER
Last Name:RAMSEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9516 S SHIELDS BLVD APT 276
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-3127
Mailing Address - Country:US
Mailing Address - Phone:405-593-2722
Mailing Address - Fax:
Practice Address - Street 1:930 WALL ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6319
Practice Address - Country:US
Practice Address - Phone:405-384-8588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKRBT-24-324927106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician