Individual
MS. LEAH SUSAN RANDOLPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC I, MM
Contact information
Practice address
21 WAUMBECK ST, DORCHESTER, MA 02121-1220
(617) 291-3623
Mailing address
21 WAUMBECK ST, DORCHESTER, MA 02121-1220
(617) 291-3623
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/29/2010
Last updated
09/29/2010
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