Provider Demographics
NPI:1265905681
Name:RAMOS, LACEY E (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:LACEY
Middle Name:E
Last Name:RAMOS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12995 N ORACLE RD STE 141
Mailing Address - Street 2:#314
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85739-9528
Mailing Address - Country:US
Mailing Address - Phone:970-819-1637
Mailing Address - Fax:
Practice Address - Street 1:38746 SOUTH RUNNING ROSES LANE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85739
Practice Address - Country:US
Practice Address - Phone:970-819-1637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-08
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYSP-886235Z00000X
AZSLP12222235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist