MEDICARE: SHAMARI N RAMIREZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1215655535
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAMARI N RAMIREZ

Provider Business Mailing Address
First Line	:	430 N PEBBLE CREEK TER APT 203
Second Line	:
City	:	MUSTANG
State	:	OK
Zip	:	73064-4183
Country	:	US
Telephone Number	:	316-293-7794
Fax Number	:

Provider Business Practice Location Address
First Line	:	3700 N CLASSEN BLVD STE 185
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73118-2881
Country	:	US
Telephone Number	:	405-225-1891
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2022
Last Update Date	:	08/22/2022

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Directions to “ SHAMARI N RAMIREZ ” Practice Location

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