Provider Demographics
NPI:1093436933
Name:RAMOS, BETINA AUDRA (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BETINA
Middle Name:AUDRA
Last Name:RAMOS
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 BROADMOOR ST
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-2734
Mailing Address - Country:US
Mailing Address - Phone:361-227-9495
Mailing Address - Fax:
Practice Address - Street 1:803 BROADMOOR ST
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-2734
Practice Address - Country:US
Practice Address - Phone:361-227-9495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115037235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty