Healthcare Provider Details

I. General information

NPI: 1235050865
Provider Name (Legal Business Name): ELIZABETH MARIE RATAJSKI SLPA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5252 E MAIN ST
MESA AZ
85205-8022
US

IV. Provider business mailing address

5052 N KENT AVE
WHITEFISH BAY WI
53217-5520
US

V. Phone/Fax

Practice location:
  • Phone: 480-935-0614
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSLPA17581
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: