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NPI Code Detail

MEDICARE: CASSIDY LAYNE RATLIFF

MEDICARE: CASSIDY LAYNE RATLIFF
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1222Q00000XDevelopmental Therapist

General Provider Information

NPI Number : 1689268989
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASSIDY LAYNE RATLIFF
Provider Business Mailing Address
First Line : 4603 TIMBERWALK CT
Second Line :
City : LA GRANGE
State : KY
Zip : 40031-6746
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4603 TIMBERWALK CT
Second Line :
City : LA GRANGE
State : KY
Zip : 40031-6746
Country : US
Telephone Number : 703-864-6695
Fax Number : 888-830-3233
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2021
Last Update Date : 03/20/2026

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Directions to “ CASSIDY LAYNE RATLIFF ” Practice Location

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