Individual
KENNETH RAMIREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1411 PROSPECT ST, TOBYHANNA, PA 18466-7779
(570) 534-5439
Mailing address
2114 TITANIA RD, TOBYHANNA, PA 18466-8266
(570) 534-5439
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
457001
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29512
OASAS CERTIFICATE
NY
Enumeration date
02/04/2014
Last updated
04/19/2022
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