Individual
EILEEN RATLIFFE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
59 E BROADWAY RD, MESA, AZ 85210-1625
(480) 358-8956
Mailing address
PO BOX 930, MESA, AZ 85211-0930
(480) 358-8956
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
47-4379249
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
47-4379249
OTHER INSURERS
AZ
05
—
47-4379249
—
AZ
Enumeration date
05/03/2018
Last updated
05/03/2018
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