1396187498 NPI number — MRS. KARA MUNOS RATLIFF M.ED., BCBA

Table of content: MRS. KARA MUNOS RATLIFF M.ED., BCBA (NPI 1396187498)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396187498 NPI number — MRS. KARA MUNOS RATLIFF M.ED., BCBA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RATLIFF
Provider First Name:
KARA
Provider Middle Name:
MUNOS
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.ED., BCBA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MUNOS
Provider Other First Name:
KARA
Provider Other Middle Name:
MICHELLE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.ED., BCBA
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1396187498
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/18/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9707 ANDERSON MILL RD
Provider Second Line Business Mailing Address:
SUITE 220
Provider Business Mailing Address City Name:
AUSTIN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78750-2298
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-423-2428
Provider Business Mailing Address Fax Number:
512-382-1190

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9707 ANDERSON MILL RD
Provider Second Line Business Practice Location Address:
SUITE 220
Provider Business Practice Location Address City Name:
AUSTIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78750-2298
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-423-2428
Provider Business Practice Location Address Fax Number:
512-382-1190
Provider Enumeration Date:
07/18/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103K00000X , with the licence number:  1-13-13709 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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