Individual
SUSAN M RAMIREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
3412 S ILLINOIS AVE, CARBONDALE, IL 62903-8362
(618) 305-0988
Mailing address
PO BOX 122, CARTERVILLE, IL 62918-0122
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PSY27983
CA
103TC0700X
Clinical Psychologist
Primary
071010852
IL
103TC1900X
Counseling Psychologist
PSY27983
CA
Other
Enumeration date
06/20/2016
Last updated
10/18/2022
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