Healthcare Provider Details

I. General information

NPI: 1285547158
Provider Name (Legal Business Name): JADA MARIE RAMIREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

289 S CULVER ST
LAWRENCEVILLE GA
30046-4805
US

IV. Provider business mailing address

115 SUDBROOK LN STE A
PIKESVILLE MD
21208-4184
US

V. Phone/Fax

Practice location:
  • Phone: 443-353-9547
  • Fax: 815-301-8671
Mailing address:
  • Phone: 443-353-9547
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: