Provider Demographics
NPI:1164808838
Name:RAMIREZ, PABLITA (BSW LSAA)
Entity Type:Individual
Prefix:
First Name:PABLITA
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:BSW LSAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 171
Mailing Address - Street 2:103 SWANNACK RD
Mailing Address - City:MESQUITE
Mailing Address - State:NM
Mailing Address - Zip Code:88048-0171
Mailing Address - Country:US
Mailing Address - Phone:575-386-1463
Mailing Address - Fax:
Practice Address - Street 1:2805 LAS VEGAS CT
Practice Address - Street 2:SUITE B
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88007-4108
Practice Address - Country:US
Practice Address - Phone:575-522-5144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-05
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0175601101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)