Individual
MISS SHANA LARRAINE RALSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
171 INTREPID LN, SYRACUSE, NY 13205-2548
(315) 437-4689
Mailing address
303 W HIGH TER, SYRACUSE, NY 13219-2432
(607) 244-5287
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
06/05/2018
Last updated
06/05/2018
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