Provider Demographics
NPI:1689140196
Name:HEARD, RATAUCHA A (CAADC, LLPC, CFTC)
Entity type:Individual
Prefix:
First Name:RATAUCHA
Middle Name:A
Last Name:HEARD
Suffix:
Gender:F
Credentials:CAADC, LLPC, CFTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31915 NEWCASTLE ST
Mailing Address - Street 2:
Mailing Address - City:ROMULUS
Mailing Address - State:MI
Mailing Address - Zip Code:48174-4304
Mailing Address - Country:US
Mailing Address - Phone:702-245-7372
Mailing Address - Fax:734-480-8686
Practice Address - Street 1:31915 NEWCASTLE ST
Practice Address - Street 2:
Practice Address - City:ROMULUS
Practice Address - State:MI
Practice Address - Zip Code:48174-4304
Practice Address - Country:US
Practice Address - Phone:702-245-7372
Practice Address - Fax:734-480-8686
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-23
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X
MI6451022645101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty