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Individual

MS. BRENDA E. WALKER RANDOLPH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
99 MAIN ST, NYACK, NY 10960-3109
(914) 391-2847
Mailing address
28 MIDWAY RD, CHESTNUT RIDGE, NY 10977-7013
(914) 391-2847

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
070720
NY
1041C0700X
Clinical Social Worker
44SC04859200
NJ

Other

Enumeration date
05/09/2008
Last updated
05/09/2008
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