Provider Demographics
NPI:1558701516
Name:RAMIREZ, ROXANNA C (BCBA)
Entity Type:Individual
Prefix:
First Name:ROXANNA
Middle Name:C
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3807 FIESTA TRL
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78245-2444
Mailing Address - Country:US
Mailing Address - Phone:210-275-2925
Mailing Address - Fax:
Practice Address - Street 1:3807 FIESTA TRL
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78245-2444
Practice Address - Country:US
Practice Address - Phone:210-275-2925
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-04
Last Update Date:2013-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-13-13439103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst