Provider Demographics
NPI:1548656010
Name:JANUARY, RATONYA
Entity type:Individual
Prefix:
First Name:RATONYA
Middle Name:
Last Name:JANUARY
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 1:1507 S 7TH ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71202-2844
Mailing Address - Country:US
Mailing Address - Phone:318-348-2972
Mailing Address - Fax:318-362-5669
Practice Address - Street 1:1507 S 7TH ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71202-2844
Practice Address - Country:US
Practice Address - Phone:318-348-2972
Practice Address - Fax:318-362-5669
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-12
Last Update Date:2015-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0000000019103K00000X, 171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No171W00000XOther Service ProvidersContractor