Provider Demographics
NPI:1467154179
Name:CARABALLO RAMOS, MARISOL N/A SR
Entity Type:Individual
Prefix:
First Name:MARISOL
Middle Name:N/A
Last Name:CARABALLO RAMOS
Suffix:SR
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 1:600 PARK GROVE DR APT 207
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-5683
Mailing Address - Country:US
Mailing Address - Phone:305-332-7982
Mailing Address - Fax:
Practice Address - Street 1:600 PARK GROVE DR APT 207
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-5683
Practice Address - Country:US
Practice Address - Phone:305-332-7982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX424292355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Single Specialty