Provider Demographics
NPI:1417510538
Name:RAMIG, RICHARD STEPHEN (RBT-19-83836)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:STEPHEN
Last Name:RAMIG
Suffix:
Gender:M
Credentials:RBT-19-83836
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37941 N HAROLD PL
Mailing Address - Street 2:
Mailing Address - City:SPRING GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60081-9407
Mailing Address - Country:US
Mailing Address - Phone:815-307-9034
Mailing Address - Fax:
Practice Address - Street 1:37941 N HAROLD PL
Practice Address - Street 2:
Practice Address - City:SPRING GROVE
Practice Address - State:IL
Practice Address - Zip Code:60081-9407
Practice Address - Country:US
Practice Address - Phone:815-307-9034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-15
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILRBT-19-83836106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician