Provider Demographics
NPI:1407566243
Name:RIVERA-RAMIREZ, DAMARIS (MSW)
Entity Type:Individual
Prefix:MRS
First Name:DAMARIS
Middle Name:
Last Name:RIVERA-RAMIREZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 W HIGHLAND ST LOT 55
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33815-4278
Mailing Address - Country:US
Mailing Address - Phone:860-409-3030
Mailing Address - Fax:863-353-9268
Practice Address - Street 1:135 N 6TH ST FL 1
Practice Address - Street 2:
Practice Address - City:HAINES CITY
Practice Address - State:FL
Practice Address - Zip Code:33844-4247
Practice Address - Country:US
Practice Address - Phone:863-409-3030
Practice Address - Fax:863-353-9268
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-02
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker