Individual
EDIE RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
900 HERITAGE DR STE 910, POTTSTOWN, PA 19464-9223
(484) 458-5138
Mailing address
331 S 13TH ST, READING, PA 19602-2049
(610) 507-6419
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PCO12565
PA
Other
Enumeration date
09/23/2020
Last updated
09/23/2020
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