Provider Demographics
NPI:1043566037
Name:RALSTON, DEBORAH ANN (MS)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:ANN
Last Name:RALSTON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 W IRONWOOD DR
Mailing Address - Street 2:SUITE D PMB 260
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-1403
Mailing Address - Country:US
Mailing Address - Phone:208-215-4071
Mailing Address - Fax:
Practice Address - Street 1:310 N RIVERPOINT BLVD
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1610
Practice Address - Country:US
Practice Address - Phone:509-505-7481
Practice Address - Fax:509-606-2515
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-27
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDTSLP-2266235Z00000X
WALL60963045235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist