Healthcare Provider Details

I. General information

NPI: 1053885228
Provider Name (Legal Business Name): MS. DAKOTA L RAMIREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/21/2019
Last Update Date: 01/01/2026
Certification Date: 01/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 JUAN TABO BLVD NE STE B
ALBUQUERQUE NM
87111-2627
US

IV. Provider business mailing address

4800 JUAN TABO BLVD NE STE B
ALBUQUERQUE NM
87111-2627
US

V. Phone/Fax

Practice location:
  • Phone: 505-888-1795
  • Fax:
Mailing address:
  • Phone: 505-888-1795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT22031
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: