Provider Demographics
NPI:1437833803
Name:RAMIREZ, KEISHLA MARIE I (SLA)
Entity Type:Individual
Prefix:
First Name:KEISHLA
Middle Name:MARIE
Last Name:RAMIREZ
Suffix:I
Gender:F
Credentials:SLA
Other - Prefix:
Other - First Name:KEISHLA
Other - Middle Name:MARIE
Other - Last Name:RAMIREZ
Other - Suffix:I
Other - Last Name Type:Former Name
Other - Credentials:SLA
Mailing Address - Street 1:B1 CALLE 3 URB. REPARTO MARQUEZ
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612
Mailing Address - Country:US
Mailing Address - Phone:787-940-6254
Mailing Address - Fax:
Practice Address - Street 1:B1 CALLE 3 URB. REPARTO MARQUEZ
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-940-6254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7556235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty