Individual
CRYSTAL RANDOLPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
1414 BRAY DR, CHARLOTTE, NC 28214-1042
(225) 454-9872
Mailing address
1414 BRAY DR, CHARLOTTE, NC 28214-1042
(225) 454-9872
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5955
LA
235Z00000X
Speech-Language Pathologist
8774
NC
Other
Enumeration date
06/16/2010
Last updated
08/10/2012
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