Provider Demographics
NPI:1164196812
Name:RATLIFF, ELLEN I (BCABA)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:I
Last Name:RATLIFF
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17532 WILLOW POND DR
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33549-5602
Mailing Address - Country:US
Mailing Address - Phone:813-598-6527
Mailing Address - Fax:
Practice Address - Street 1:17532 WILLOW POND DR
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33549-5602
Practice Address - Country:US
Practice Address - Phone:813-598-6527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-05
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician