Basic Information
| Provider Information | |||||||||
| NPI: | 1710650635 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RALFS | ||||||||
| FirstName: | ANNA | ||||||||
| MiddleName: | KATHRYN NORDHOFF | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LGPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 202 COURSEVALL DR | ||||||||
| Address2: | |||||||||
| City: | CENTREVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 216172804 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 202 COURSEVALL DR | ||||||||
| Address2: | |||||||||
| City: | CENTREVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 216172804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4435829213 | ||||||||
| FaxNumber: | 8885090010 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2021 | ||||||||
| LastUpdateDate: | 06/24/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | LGP11643 | MD | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.