Provider Demographics
NPI:1184394801
Name:RALSTON, KAREN ANN (MSCCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:ANN
Last Name:RALSTON
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 MILLVILLE ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-2615
Mailing Address - Country:US
Mailing Address - Phone:603-893-7059
Mailing Address - Fax:603-893-7060
Practice Address - Street 1:54 MILLVILLE ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-2615
Practice Address - Country:US
Practice Address - Phone:603-893-7059
Practice Address - Fax:603-893-7060
Is Sole Proprietor?:No
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0577235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist