Provider Demographics
NPI:1306313184
Name:RAMSKOGLER, JESSICA
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:RAMSKOGLER
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 1:12822 DONEGAL LN
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:GA
Mailing Address - Zip Code:30004-8105
Mailing Address - Country:US
Mailing Address - Phone:470-308-6150
Mailing Address - Fax:
Practice Address - Street 1:168 N. JOHNSON ST
Practice Address - Street 2:SUITE 304
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30132
Practice Address - Country:US
Practice Address - Phone:470-308-6150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-30
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA104012101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional