MEDICARE: DR. SYMA ROSE RALSTON PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	04100	MD

General Provider Information

NPI Number	:	1669673240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SYMA ROSE RALSTON PSYD

Provider Business Mailing Address
First Line	:	1311 XAVERIA DRIVE
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20903-1636
Country	:	US
Telephone Number	:	301-565-0622
Fax Number	:	301-565-0622

Provider Business Practice Location Address
First Line	:	1311 XAVERIA DRIVE
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20903-1636
Country	:	US
Telephone Number	:	301-565-0622
Fax Number	:	301-565-0622

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2007
Last Update Date	:	07/08/2007

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