Healthcare Provider Details

I. General information

NPI: 1538490388
Provider Name (Legal Business Name): ANNMARIE RAMBO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNMARIE SPRUILL

II. Dates (important events)

Enumeration Date: 01/19/2010
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 NORTHSIDE XING STE A
MACON GA
31210-2377
US

IV. Provider business mailing address

500 NORTHSIDE XING STE A
MACON GA
31210-2377
US

V. Phone/Fax

Practice location:
  • Phone: 855-832-6727
  • Fax:
Mailing address:
  • Phone: 855-832-6727
  • Fax: 772-675-9100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: