Individual
DAVIDA ELAINE RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
333 E CAMPUS MALL, MADISON, WI 53715-1365
(608) 890-1345
Mailing address
333 E CAMPUS MALL, MADISON, WI 53715-1365
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7123
WI
Other
Enumeration date
12/08/2023
Last updated
12/08/2023
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