Provider Demographics
NPI:1780412791
Name:RALPH, ATHALIA FAITH SADIE
Entity type:Individual
Prefix:
First Name:ATHALIA
Middle Name:FAITH SADIE
Last Name:RALPH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 CALLENDER AVE
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:RI
Mailing Address - Zip Code:02840-2078
Mailing Address - Country:US
Mailing Address - Phone:401-497-2559
Mailing Address - Fax:
Practice Address - Street 1:38 CALLENDER AVE
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:RI
Practice Address - Zip Code:02840-2078
Practice Address - Country:US
Practice Address - Phone:401-497-2559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program