Individual
KELLY ANNE RALPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
50 LASER CT, HAUPPAUGE, NY 11788-3958
(631) 853-2379
Mailing address
50 LASER CT, HAUPPAUGE, NY 11788-3958
(631) 853-2379
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
055195-1
NY
Other
Enumeration date
06/07/2012
Last updated
06/07/2012
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