Provider Demographics
NPI:1154386027
Name:RALSTON, KATHLEEN PATRICIA (CNC, ND,PHD,CNHP)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:PATRICIA
Last Name:RALSTON
Suffix:
Gender:F
Credentials:CNC, ND,PHD,CNHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3518 ANGUS VALLEY TRL
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-3755
Mailing Address - Country:US
Mailing Address - Phone:301-219-6111
Mailing Address - Fax:
Practice Address - Street 1:7231 RITCHIE HWY
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-6900
Practice Address - Country:US
Practice Address - Phone:301-219-6111
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath