| NPI | 1134482599 |
|---|---|
| Former Name | AMANDA JEAN RALSTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: ND 1278) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MN 104259) |
| 225XP0019X Occupational Therapist Physical Rehabilitation (Licence: MN 104259) | |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2018-06-26 |