Provider Demographics
NPI:1053465294
Name:RATSPRECHER, DANA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:
Last Name:RATSPRECHER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6658 MONTEGO BAY BLVD APT F
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-4060
Mailing Address - Country:US
Mailing Address - Phone:954-629-0435
Mailing Address - Fax:
Practice Address - Street 1:9033 GLADES RD
Practice Address - Street 2:B
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-3939
Practice Address - Country:US
Practice Address - Phone:561-361-0500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY002967103TC0700X
NY016569103TC0700X
FLPY7277103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA606359339BMedicaid