Provider Demographics
NPI:1750137717
Name:RAMIREZ, GENESIS D (RBT)
Entity type:Individual
Prefix:
First Name:GENESIS
Middle Name:D
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:LA MARQUE
Mailing Address - State:TX
Mailing Address - Zip Code:77568-5700
Mailing Address - Country:US
Mailing Address - Phone:409-749-7432
Mailing Address - Fax:
Practice Address - Street 1:6807 EMMETT F LOWRY EXPY STE 105
Practice Address - Street 2:
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77591-2543
Practice Address - Country:US
Practice Address - Phone:409-229-4280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-24-3082-719558106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician