Individual
MRS. WENDY REED RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.A.S.
Contact information
Practice address
6029 CLAPTON DR, WAKE FOREST, NC 27587-4263
(262) 960-4739
Mailing address
6029 CLAPTON DR, WAKE FOREST, NC 27587-4263
(262) 960-4739
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1492
NC
Other
Enumeration date
08/03/2009
Last updated
10/04/2012
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