Provider Demographics
NPI:1609383116
Name:RAMIREZ, TONY (BCBA, LBA)
Entity type:Individual
Prefix:
First Name:TONY
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:VICENTE
Other - Middle Name:ANTONIO
Other - Last Name:RAMIREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:526 GAFFNEY RD, STE 100
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701
Mailing Address - Country:US
Mailing Address - Phone:907-687-5332
Mailing Address - Fax:907-312-2399
Practice Address - Street 1:526 GAFFNEY RD, STE 100
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701
Practice Address - Country:US
Practice Address - Phone:907-687-5332
Practice Address - Fax:907-312-2399
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-05
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
AK214102103K00000X
WABA61355480103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst