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General NPI Number Information
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NPI Number | 1477571511
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Entity Type | Individual
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Provider Name | BRENDA JEAN RATCLIFF PH.D.
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Gender | Female
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 05/18/2010
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Provider Practice Location Address
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Address Line | 5770 PLANK RD
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City | NATURAL BRIDGE
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State | VA
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Zip | 24578-4039
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Country | US
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Telephone | 540-529-1124
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Fax | 540-291-8339
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Provider Business Mailing Address
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Address Line | 5770 PLANK RD
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City | NATURAL BRIDGE
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State | VA
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Zip | 24578-4039
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Country | US
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Telephone | 540-529-1124
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Fax | 540-291-8339
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 0811000003
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License Number State | VA
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