Provider Demographics
NPI:1063956514
Name:CASARRUBIAS RAMIREZ, MARIA ANALI
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ANALI
Last Name:CASARRUBIAS RAMIREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 STACY WEAVER DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28311-0858
Mailing Address - Country:US
Mailing Address - Phone:919-464-6688
Mailing Address - Fax:
Practice Address - Street 1:1830 OWEN DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-1611
Practice Address - Country:US
Practice Address - Phone:910-748-0258
Practice Address - Fax:910-745-8405
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-16
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106E00000X
NC30001383235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst