Individual
MRS. LISA S. RALSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OTR L
Contact information
Practice address
3038 ST. CHARLES AVE., 3038 ST. CHARLES AVE., GAINESVILLE, GA 30504
(770) 654-0667
(770) 531-9330
Mailing address
P. O. BOX 7475, 3038 ST. CHARLES AVE., GAINESVILLE, GA 30504
(770) 654-0667
(770) 531-9330
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3484
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00932764A
—
GA
Enumeration date
01/17/2007
Last updated
07/09/2007
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