Individual
VALERIA RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25024 GILMAR CT, NORTH DINWIDDIE, VA 23803-8615
(804) 898-6102
Mailing address
25024 GILMAR CT, NORTH DINWIDDIE, VA 23803-8615
(804) 898-6102
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0710102445
VA
101YM0800X
Mental Health Counselor
0732001983
VA
Other
Enumeration date
02/20/2019
Last updated
02/20/2019
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