Provider Demographics
NPI:1932455201
Name:RATCHFORD, MARIE B
Entity Type:Individual
Prefix:MS
First Name:MARIE
Middle Name:B
Last Name:RATCHFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MARIE
Other - Middle Name:B
Other - Last Name:SORICELLI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:25 TINKER ST
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:NY
Mailing Address - Zip Code:12498-1234
Mailing Address - Country:US
Mailing Address - Phone:518-847-9761
Mailing Address - Fax:
Practice Address - Street 1:20 MANCHESTER RD
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-2412
Practice Address - Country:US
Practice Address - Phone:845-486-2950
Practice Address - Fax:845-486-2999
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY072872-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker