Provider Demographics
NPI:1548820392
Name:RAMIREZ, EDITH AYDEE (COTA)
Entity type:Individual
Prefix:
First Name:EDITH
Middle Name:AYDEE
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1826 JACK NICKLAUS DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79935-3010
Mailing Address - Country:US
Mailing Address - Phone:915-202-9347
Mailing Address - Fax:
Practice Address - Street 1:1826 JACK NICKLAUS DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935-3010
Practice Address - Country:US
Practice Address - Phone:915-202-9347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-14
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX214149224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant