Provider Demographics
NPI:1346469152
Name:RATLIFF, RICCI R (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:RICCI
Middle Name:R
Last Name:RATLIFF
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 NE 4TH ST
Mailing Address - Street 2:
Mailing Address - City:ENGLAND
Mailing Address - State:AR
Mailing Address - Zip Code:72046-1323
Mailing Address - Country:US
Mailing Address - Phone:501-842-2657
Mailing Address - Fax:
Practice Address - Street 1:700 MOODY DR
Practice Address - Street 2:
Practice Address - City:WHITE HALL
Practice Address - State:AR
Practice Address - Zip Code:71602-9503
Practice Address - Country:US
Practice Address - Phone:870-247-4363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#1582235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist