Provider Demographics
NPI:1932358751
Name:RATLIFF, PEGGY SUE (LPC)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:SUE
Last Name:RATLIFF
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:PEGGY
Other - Middle Name:S
Other - Last Name:ZINI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:11 OAK CLIFF CV
Mailing Address - Street 2:
Mailing Address - City:DAMASCUS
Mailing Address - State:AR
Mailing Address - Zip Code:72039-9265
Mailing Address - Country:US
Mailing Address - Phone:501-335-9278
Mailing Address - Fax:
Practice Address - Street 1:1058 FRONT ST STE 104
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-4337
Practice Address - Country:US
Practice Address - Phone:501-504-2092
Practice Address - Fax:501-504-2093
Is Sole Proprietor?:No
Enumeration Date:2008-09-17
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP2308029101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health