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General NPI Number Information
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NPI Number | 1689415598
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Entity Type | Individual
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Provider Name | VIVIAN JOHANNA RAMIREZ LMSW
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Gender | Female
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Dates
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Enumeration Date | 06/04/2024
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 2240 WINROW RD
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City | FORT HUACHUCA
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State | AZ
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Zip | 85613-5080
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Country | US
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Telephone | 786-585-6467
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Fax |
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Provider Business Mailing Address
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Address Line | 409 S LENZNER AVE APT 12202
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City | SIERRA VISTA
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State | AZ
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Zip | 85635-5653
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Country | US
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Telephone | 786-585-6467
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 113319
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License Number State | TX
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