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Individual

MR. JASON LEWIS RATLIFF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
404 HOLSTON DR, GREENEVILLE, TN 37743-3126
(423) 638-4171
Mailing address
257 HILL TOP CIR, BLUFF CITY, TN 37618-1632
(423) 366-3177

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3013231
TN
01
3697678
MEDICARE
TN
Enumeration date
02/13/2007
Last updated
09/08/2008
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