Individual provider · NPI-1

Delta Rudeen Ralph

Marriage & Family Therapist · Port St Lucie, FL

NPI number1043917289
StatusActive
Last updated in NPPESFeb 8, 2023

Details

NPI
1043917289
Entity type
Individual (NPI-1)
Name
Delta Rudeen Ralph
Sex
Female
Sole proprietor
No
Enumeration date
Feb 8, 2023
Certification date
Feb 8, 2023
Last updated
Feb 8, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
106H00000X Marriage & Family Therapist––Yes
101Y00000X Counselor––

Practice location

567 Nw Lake Whitney Pl Ste 101
Port St Lucie, FL 34986-1629

Phone 309-262-7653

Mailing address

567 Nw Lake Whitney Pl Ste 101
Port St Lucie, FL 34986-1629

Phone 309-262-7653

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