Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 1907657 | IL |
NPI | 1083375257 |
---|---|
Provider Name | Dr. Courtney Dawn Ratliff |
First Address | Algonquin, IL 60102-2708 |
Second Address | Algonquin, IL 60102-2708 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2022 |
Last Update Date | 10/01/2022 |