Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 3909 | CO |
Y | 225XP0200X | Occupational Therapist - Pediatrics | 16533 | FL |
N | 225XP0200X | Occupational Therapist - Pediatrics | 322910 | OR |
N | 225XP0200X | Occupational Therapist - Pediatrics | 5730 | AZ |
NPI | 1033534755 |
---|---|
Provider Name | Shauna Jenee Ratcliff |
First Address | Avon, CO 81620-2474 |
Second Address | Edwards, CO 81632-6433 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2014 |
Last Update Date | 16/02/2021 |