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General NPI Number Information
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NPI Number | 1578200960
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Entity Type | Individual
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Provider Name | LA'TANYA RAMOS
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Gender | Female
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Dates
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Enumeration Date | 05/17/2022
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Last Update Date | 07/22/2023
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Provider Practice Location Address
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Address Line | 5845 YADKIN RD STE D
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City | FAYETTEVILLE
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State | NC
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Zip | 28303-2656
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Country | US
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Telephone | 910-867-4417
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Fax |
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Provider Business Mailing Address
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Address Line | 122 LONGLEAF PINE WAY
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City | SANFORD
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State | NC
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Zip | 27332-2550
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Country | US
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Telephone | 757-232-7677
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 00557
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License Number State | NC
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