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Individual

GALE LORRAINE RANDOLPH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
404 E 3RD ST STE 200, FARMVILLE, VA 23901-1512
(434) 808-9291
Mailing address
PO BOX 796, FARMVILLE, VA 23901-0796
(434) 808-9291

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701008626
VA

Other

Enumeration date
11/15/2019
Last updated
11/15/2019
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