Provider Demographics
NPI:1548938558
Name:ROBERTS, RAMSEY (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:RAMSEY
Middle Name:
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 LIVE OAK RD
Mailing Address - Street 2:
Mailing Address - City:SANTO
Mailing Address - State:TX
Mailing Address - Zip Code:76472-3825
Mailing Address - Country:US
Mailing Address - Phone:940-328-2359
Mailing Address - Fax:
Practice Address - Street 1:1100 LONGHORN DR
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086-5095
Practice Address - Country:US
Practice Address - Phone:817-598-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-03
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX116056235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX116056OtherTEXAS SPEECH LANGUAGE PATHOLOGY LICENSURE