Individual
SUSAN RANDOLPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
233 HYDRAULIC RIDGE RD, 205, CHARLOTTESVILLE, VA 22901-8129
(434) 409-9367
Mailing address
233 HYDRAULIC RIDGE RD, 205, CHARLOTTESVILLE, VA 22901-8129
(434) 409-9367
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701003379
VA
Other
Enumeration date
07/30/2014
Last updated
07/30/2014
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