Provider Demographics
NPI:1275362790
Name:RATLIFF, HEATHER LEIGH
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:LEIGH
Last Name:RATLIFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 LAUREN DR
Mailing Address - Street 2:
Mailing Address - City:VILLA HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41017-4490
Mailing Address - Country:US
Mailing Address - Phone:859-801-2811
Mailing Address - Fax:
Practice Address - Street 1:1005 LAUREN DR
Practice Address - Street 2:
Practice Address - City:VILLA HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-4490
Practice Address - Country:US
Practice Address - Phone:859-801-2811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-01
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY200176097222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist