Provider Demographics
NPI:1952991994
Name:RAMIREZ, JACQUELYN VICTORI (M ED, RBT)
Entity Type:Individual
Prefix:
First Name:JACQUELYN
Middle Name:VICTORI
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:M ED, RBT
Other - Prefix:
Other - First Name:JACKIE
Other - Middle Name:
Other - Last Name:RAMIREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:439 W HARRIS AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76903-6392
Mailing Address - Country:US
Mailing Address - Phone:325-939-2650
Mailing Address - Fax:
Practice Address - Street 1:2713 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76904-5321
Practice Address - Country:US
Practice Address - Phone:281-685-8370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-23
Last Update Date:2021-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-20-148509106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician