Provider Demographics
NPI:1295403913
Name:RAMER, MAUREEN S (CSUDC)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:S
Last Name:RAMER
Suffix:
Gender:F
Credentials:CSUDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:561 E TABERNACLE ST
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-2944
Mailing Address - Country:US
Mailing Address - Phone:435-673-2899
Mailing Address - Fax:
Practice Address - Street 1:561 E TABERNACLE ST
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-2944
Practice Address - Country:US
Practice Address - Phone:435-673-2899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-30
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12020976-6005101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty