Individual
SHASHA RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
16 MARSHALL ST APT 1W, IRVINGTON, NJ 07111-8636
(862) 220-3198
Mailing address
16 MARSHALL ST APT 1W, IRVINGTON, NJ 07111-8636
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
103849
NY
104100000X
Social Worker
44SL06330700
NJ
1041S0200X
School Social Worker
1073091
NJ
Other
Enumeration date
12/06/2019
Last updated
12/06/2019
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