Provider Demographics
NPI:1417423120
Name:RATTO, DONNA KAREN
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:KAREN
Last Name:RATTO
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 1:590 E RIPLEY ST
Mailing Address - Street 2:
Mailing Address - City:BYARS
Mailing Address - State:OK
Mailing Address - Zip Code:74831-7003
Mailing Address - Country:US
Mailing Address - Phone:405-596-6985
Mailing Address - Fax:
Practice Address - Street 1:119 N BROADWAY AVE STE 13
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820-5049
Practice Address - Country:US
Practice Address - Phone:580-559-2347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-19
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management