Individual
ELIZABETH RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD, LMHC
Contact information
Practice address
800 HERTEL AVE STE 101, BUFFALO, NY 14207-1906
(171) 656-6505
Mailing address
800 HERTEL AVE STE 101, BUFFALO, NY 14207-1906
(171) 656-6505
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
007768
NY
103T00000X
Psychologist
Primary
023579
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01465451
—
NY
Enumeration date
03/21/2018
Last updated
02/10/2022
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