Individual
JENNIFER E RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
46 LOCHOA DR, DAVIS, WV 26260-8072
(304) 435-7658
Mailing address
20 KNOB VISTA RD, BUCKHANNON, WV 26201-4563
(304) 435-7658
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2115
WV
Other
Enumeration date
06/10/2015
Last updated
06/10/2015
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