Individual
MRS. RANDI LEE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN IBCLC
Contact information
Practice address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3307
(703) 776-4402
Mailing address
3456 CALEDONIA CIR, WOODBRIDGE, VA 22192-1073
(315) 730-6366
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
0001268199
VA
Other
Enumeration date
11/12/2025
Last updated
11/19/2025
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