Provider Demographics
NPI:1033534755
Name:RATCLIFF, SHAUNA JENEE (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:SHAUNA
Middle Name:JENEE
Last Name:RATCLIFF
Suffix:
Gender:F
Credentials:MS, OTR/L
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 2474
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:CO
Mailing Address - Zip Code:81620-2474
Mailing Address - Country:US
Mailing Address - Phone:303-918-1156
Mailing Address - Fax:
Practice Address - Street 1:320 BEARD CREEK RD
Practice Address - Street 2:
Practice Address - City:EDWARDS
Practice Address - State:CO
Practice Address - Zip Code:81632-6433
Practice Address - Country:US
Practice Address - Phone:970-569-7777
Practice Address - Fax:970-470-6698
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-04
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3909225X00000X
AZ5730225XP0200X
OR322910225XP0200X
FL16533225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist