Individual
DR. MADINAH IKHLAS RALSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1631 PHOENIX BLVD, SUITE 5, COLLEGE PARK, GA 30349-5545
(770) 909-6550
(770) 909-6551
Mailing address
7059 RED MAPLE LN, LITHONIA, GA 30058-2998
(404) 432-5259
(770) 482-7868
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY003079
GA
Other
Enumeration date
05/01/2007
Last updated
07/08/2007
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