Individual
TARA LYNN RANDOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1305 DARES BEACH RD, PRINCE FREDERICK, MD 20678-4208
(443) 550-8345
Mailing address
3808 BOSTWYCK DR, FUQUAY VARINA, NC 27526-7525
(808) 346-5651
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
09215
MD
Other
Enumeration date
09/11/2019
Last updated
09/11/2019
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