Provider Demographics
NPI:1326549569
Name:RAMIREZ, KELLIE MICHELE
Entity Type:Individual
Prefix:
First Name:KELLIE
Middle Name:MICHELE
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:296 COUNTY ROAD 833
Mailing Address - Street 2:
Mailing Address - City:BUNA
Mailing Address - State:TX
Mailing Address - Zip Code:77612-2776
Mailing Address - Country:US
Mailing Address - Phone:409-622-0826
Mailing Address - Fax:
Practice Address - Street 1:296 COUNTY ROAD 833
Practice Address - Street 2:
Practice Address - City:BUNA
Practice Address - State:TX
Practice Address - Zip Code:77612-2776
Practice Address - Country:US
Practice Address - Phone:409-622-0826
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-22
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX385542355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant