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General NPI Number Information
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NPI Number | 1629286992
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Entity Type | Individual
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Provider Name | ELIZABETH RATLEDGE LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/19/2007
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Last Update Date | 04/11/2019
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Provider Practice Location Address
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Address Line | 6098 DEBRA RD
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City | CHATTANOOGA
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State | TN
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Zip | 37411-5702
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Country | US
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Telephone | 423-893-6500
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Fax |
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Provider Business Mailing Address
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Address Line | 424 N HOUSTON ST
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City | MARYVILLE
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State | TN
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Zip | 37801-4736
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Country | US
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Telephone | 865-660-7050
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LSW0000004289
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License Number State | TN
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