Healthcare Provider Details

I. General information

NPI: 1689682833
Provider Name (Legal Business Name): CHRISTOPHER RATZLAFF LMLP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E CENTENNIAL DR SUITE 200
PITTSBURG KS
66762-6559
US

IV. Provider business mailing address

PO BOX 1266
PITTSBURG KS
66762-1266
US

V. Phone/Fax

Practice location:
  • Phone: 620-231-1068
  • Fax: 620-235-7913
Mailing address:
  • Phone: 620-232-0444
  • Fax: 620-235-7913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number868
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: