Healthcare Provider Details

I. General information

NPI: 1871336735
Provider Name (Legal Business Name): MADISON RATLIFF SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2024
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1429 CLEAR LAKE RD STE 200
WEATHERFORD TX
76086-8801
US

IV. Provider business mailing address

8101 BOAT CLUB RD STE 240-319
FORT WORTH TX
76179-3630
US

V. Phone/Fax

Practice location:
  • Phone: 682-231-1720
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number122568
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: