Provider Demographics
NPI:1740977768
Name:RAMOS, LILIANA
Entity type:Individual
Prefix:
First Name:LILIANA
Middle Name:
Last Name:RAMOS
Suffix:
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 1:1300 INDEPENDENCE PLACE DR APT 622
Mailing Address - Street 2:
Mailing Address - City:HINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31313-9615
Mailing Address - Country:US
Mailing Address - Phone:787-452-8754
Mailing Address - Fax:
Practice Address - Street 1:1300 INDEPENDENCE PLACE DR APT 622
Practice Address - Street 2:
Practice Address - City:HINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:31313-9615
Practice Address - Country:US
Practice Address - Phone:787-452-8754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARBT-23-269185106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician