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Individual

MRS. CARMEN MARIA RANDOLPH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNA

Contact information

Practice address
407 W PEMBROKE AVE, N/A, HAMPTON, VA 23669-3432
(757) 763-7010
(757) 763-7010
Mailing address
407 W PEMBROKE AVE, N/A, HAMPTON, VA 23669-3432
(757) 763-7010
(757) 763-7010

Taxonomy

Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
372600000X
VA

Other

Enumeration date
09/21/2015
Last updated
09/21/2015
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