Healthcare Provider Details

I. General information

NPI: 1770787236
Provider Name (Legal Business Name): MONICA ELENA RAMIREZ M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1353 N WESTMORELAND RD
DALLAS TX
75211-1655
US

IV. Provider business mailing address

2120 BRENTWOOD LN
CARROLLTON TX
75006-1834
US

V. Phone/Fax

Practice location:
  • Phone: 214-331-0115
  • Fax:
Mailing address:
  • Phone: 972-236-8258
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License NumberP1156
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: