Provider Demographics
NPI:1174895783
Name:RAMOS, CARRIE ANNE
Entity type:Individual
Prefix:MS
First Name:CARRIE
Middle Name:ANNE
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:PO BOX 1213
Mailing Address - Street 2:
Mailing Address - City:TAHLEQUAH
Mailing Address - State:OK
Mailing Address - Zip Code:74465-1213
Mailing Address - Country:US
Mailing Address - Phone:918-207-7823
Mailing Address - Fax:
Practice Address - Street 1:17691 W WEDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:TAHLEQUAH
Practice Address - State:OK
Practice Address - Zip Code:74464-7423
Practice Address - Country:US
Practice Address - Phone:918-207-7823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-30
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health