Individual
MRS. JENNA MARIE RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.CCC/SLP
Contact information
Practice address
300 BAKER LN, CHARLESTON, WV 25302-2900
(304) 345-0867
(304) 342-2587
Mailing address
6036 E PEA RIDGE RD, HUNTINGTON, WV 25705-2622
(304) 280-5958
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-1333
WV
Other
Enumeration date
06/17/2010
Last updated
08/09/2013
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