Provider Demographics
NPI:1497841829
Name:RALPH, DEBORAH MALONE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:MALONE
Last Name:RALPH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 E PARHAM RD STE B
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23228-2760
Mailing Address - Country:US
Mailing Address - Phone:804-901-3122
Mailing Address - Fax:804-755-1215
Practice Address - Street 1:4100 E PARHAM RD STE B
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23228-2760
Practice Address - Country:US
Practice Address - Phone:804-901-3122
Practice Address - Fax:804-755-1215
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904002796174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist