Individual
MR. RANDALL EDWARD SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10TH SIXTH AVENUE WEST, HUNTINGTON, WV 25701
(304) 525-8014
Mailing address
10 6TH AVE W, HUNTINGTON, WV 25701-0028
(304) 525-8014
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-25-84111
WV
Other
Enumeration date
07/30/2020
Last updated
09/23/2025
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