Provider Demographics
NPI:1164508529
Name:RATLEY, CARLY BRIANNA (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CARLY
Middle Name:BRIANNA
Last Name:RATLEY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37110-2515
Mailing Address - Country:US
Mailing Address - Phone:931-474-3086
Mailing Address - Fax:
Practice Address - Street 1:201 W MAIN ST STE 104
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:TN
Practice Address - Zip Code:37110-2581
Practice Address - Country:US
Practice Address - Phone:931-474-3086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-28
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3265235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist