Provider Demographics
NPI:1063681781
Name:RATLIFF, JANET SUE
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:SUE
Last Name:RATLIFF
Suffix:
Gender:F
Credentials:
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 494
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47308-0494
Mailing Address - Country:US
Mailing Address - Phone:765-749-3476
Mailing Address - Fax:765-287-1363
Practice Address - Street 1:4005 W BROOK DR
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-2974
Practice Address - Country:US
Practice Address - Phone:765-749-3476
Practice Address - Fax:765-749-3476
Is Sole Proprietor?:No
Enumeration Date:2008-02-27
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22001409A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist