Provider Demographics
NPI:1730994997
Name:GRAMAJO, KATIE PAMELA (MA, BCBA)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:PAMELA
Last Name:GRAMAJO
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 HUNTERS TRCE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30157-9427
Mailing Address - Country:US
Mailing Address - Phone:678-925-9338
Mailing Address - Fax:
Practice Address - Street 1:101 BAINBRIDGE WAY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30132-4765
Practice Address - Country:US
Practice Address - Phone:770-456-0762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1-25-79208103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst