Provider Demographics
NPI:1285416073
Name:MARTI RAMIREZ, JESSICA (RBT)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:MARTI RAMIREZ
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:727 SW 7TH AVE APT 1A
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-6977
Mailing Address - Country:US
Mailing Address - Phone:786-906-6243
Mailing Address - Fax:
Practice Address - Street 1:727 SW 7TH AVE APT 1A
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-6977
Practice Address - Country:US
Practice Address - Phone:786-906-6243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-304022106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty