Provider Demographics
NPI:1689977597
Name:RATLIFF, DUSTIN JAMES
Entity Type:Individual
Prefix:
First Name:DUSTIN
Middle Name:JAMES
Last Name:RATLIFF
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 E PARK AVE
Mailing Address - Street 2:
Mailing Address - City:ANACONDA
Mailing Address - State:MT
Mailing Address - Zip Code:59711-2340
Mailing Address - Country:US
Mailing Address - Phone:406-563-8117
Mailing Address - Fax:406-563-5956
Practice Address - Street 1:3420 15TH AVE. S
Practice Address - Street 2:AWARE INC. MOUNTAIN VIEW SCHOOL
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-5514
Practice Address - Country:US
Practice Address - Phone:406-268-7321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-15
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor