Provider Demographics
NPI:1679807960
Name:KAYE B RATZLAFF, LPC, PLLC
Entity Type:Organization
Organization Name:KAYE B RATZLAFF, LPC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KAYE
Authorized Official - Middle Name:B
Authorized Official - Last Name:RATZLAFF
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:903-232-8900
Mailing Address - Street 1:108 WAIN DR
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75604-1231
Mailing Address - Country:US
Mailing Address - Phone:903-232-8900
Mailing Address - Fax:903-236-8510
Practice Address - Street 1:108 WAIN DR
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75604-1231
Practice Address - Country:US
Practice Address - Phone:903-232-8900
Practice Address - Fax:903-236-8510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-20
Last Update Date:2009-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17718101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty