Individual
MRS. AMY L. RALSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
501 COLLIERS WAY, WEIRTON, WV 26062-5003
(304) 723-5440
(304) 723-0665
Mailing address
501 COLLIERS WAY, WEIRTON, WV 26062-5003
(304) 723-5440
(304) 723-0665
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
BP00939521
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005456001
—
WV
01
—
001718899
MSBCBS ID NUMBER
WV
01
—
2070076
CIGNA ID NUMBER
WV
01
—
276942000
MAGELLAN ID NUMBER
WV
01
—
Y525231
HEALTH PLAN ID NUMBER
WV
Enumeration date
12/06/2006
Last updated
05/26/2010
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