Individual
RANDALL RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5501 DELMAR BLVD FL 3, SAINT LOUIS, MO 63112-3054
(314) 469-4908
Mailing address
5501 DELMAR BLVD FL 3, SAINT LOUIS, MO 63112-3054
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/09/2023
Last updated
05/09/2023
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