MEDICARE: DIVINA MARIE RAMOS LPCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	0124201	NM

General Provider Information

NPI Number	:	1285844373
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIVINA MARIE RAMOS LPCC

Provider Business Mailing Address
First Line	:	2260 STONE PINE DR
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88012-6195
Country	:	US
Telephone Number	:	575-571-7449
Fax Number	:

Provider Business Practice Location Address
First Line	:	2260 STONE PINE DR
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88012-6195
Country	:	US
Telephone Number	:	575-571-7449
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	01/08/2016

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