Provider Demographics
NPI:1316080294
Name:RAMOS-RUDIGER, DEBBIE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:DEBBIE
Middle Name:
Last Name:RAMOS-RUDIGER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 FLINTRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:HOLBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11741-2806
Mailing Address - Country:US
Mailing Address - Phone:631-472-3877
Mailing Address - Fax:
Practice Address - Street 1:24 FLINTRIDGE DR
Practice Address - Street 2:
Practice Address - City:HOLBROOK
Practice Address - State:NY
Practice Address - Zip Code:11741-2806
Practice Address - Country:US
Practice Address - Phone:631-472-3877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY03355211041C0700X
NY6670829611041S0200X
NY08349611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical