Provider Demographics
NPI:1730525155
Name:RAMOS LASSUS, THELMA DAMARIS (TDRL)
Entity type:Individual
Prefix:
First Name:THELMA
Middle Name:DAMARIS
Last Name:RAMOS LASSUS
Suffix:
Gender:F
Credentials:TDRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 617
Mailing Address - Street 2:
Mailing Address - City:ARROYO
Mailing Address - State:PR
Mailing Address - Zip Code:00714-0617
Mailing Address - Country:US
Mailing Address - Phone:178-783-9418
Mailing Address - Fax:
Practice Address - Street 1:BDA. MARIN,LOS MILLONARIOS STREET,80
Practice Address - Street 2:
Practice Address - City:ARROYO
Practice Address - State:PR
Practice Address - Zip Code:00714
Practice Address - Country:US
Practice Address - Phone:787-839-4184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-13
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10283104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker