MEDICARE: KELLIE MICHELE RAMIREZ M.S., CCC-SLP

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	235Z00000X	Speech-Language Pathologist	121637

General Provider Information

NPI Number	:	1326549569
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLIE MICHELE RAMIREZ M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	2015 COUNTY ROAD 3076
Second Line	:
City	:	CALL
State	:	TX
Zip	:	75933-3469
Country	:	US
Telephone Number	:	409-622-0826
Fax Number	:

Provider Business Practice Location Address
First Line	:	890 E HOUSTON ST
Second Line	:
City	:	JASPER
State	:	TX
Zip	:	75951-4214
Country	:	US
Telephone Number	:	409-384-1157
Fax Number	:

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

Provider Enumeration Date	:	02/22/2018
Last Update Date	:	08/15/2024

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Directions to “ KELLIE MICHELE RAMIREZ M.S., CCC-SLP” Practice Location

Language	Start Address	Practice Location

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