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General NPI Number Information
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NPI Number | 1477912160
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Entity Type | Organization
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Legal Business Name | BECKY RATTRAY LPCC
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Dates
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Enumeration Date | 02/23/2016
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Last Update Date | 02/23/2016
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Provider Practice Location Address
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Address Line | 125 CHENOWETH LN SUITE 311
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City | LOUISVILLE
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State | KY
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Zip | 40207-2641
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Country | US
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Telephone | 502-489-1032
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Fax |
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Provider Business Mailing Address
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Address Line | 125 CHENOWETH LN SUITE 311
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City | LOUISVILLE
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State | KY
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Zip | 40207-2641
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Country | US
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Telephone | 502-489-1032
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Fax |
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Authorized Official
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Title or Position | PROFESSIONAL COUNSELOR
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Name | REBECCA RATTRAY
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Credential | M. ED. LPCC
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Telephone | 502-489-1032
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPCPCC00223775
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License Number State | KY
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