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General NPI Number Information
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NPI Number | 1679910525
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Entity Type | Individual
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Provider Name | LIANA MICHELLE RATCLIFF BCABA
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Gender | Female
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Dates
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Enumeration Date | 06/03/2013
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Last Update Date | 01/16/2023
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Provider Practice Location Address
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Address Line | 14799 DIX - TOLEDO TEAM MENTAL HEALTH SVCS
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City | SOUTHGATE
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State | MI
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Zip | 48195
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Country | US
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Telephone | 734-324-8326
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Fax | 734-324-8327
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Provider Business Mailing Address
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Address Line | 9410 E PICKWICK CIR
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City | TAYLOR
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State | MI
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Zip | 48180-3855
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Country | US
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Telephone | 313-204-5507
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | L2431211
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State | MI
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