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Individual

MR. ILDEFONSO RAMIREZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MED

Contact information

Practice address
720 W CHEYENNE AVE STE 20, NORTH LAS VEGAS, NV 89030-7817
(702) 487-5665
Mailing address
568 ENGEL WAY, HENDERSON, NV 89011-4432
(484) 201-9089

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
12345678
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
25390920
PA
Enumeration date
06/26/2013
Last updated
06/26/2013
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