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Individual

DR. RYAN A RANDALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCP

Contact information

Practice address
1775 FORRESTAL DR BLDG 33, NORFOLK, VA 23551-0001
(757) 327-1076
Mailing address
168 MARINA WYND WAY, SNEADS FERRY, NC 28460-9104
(757) 327-1076

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
VA
103TC0700X
Clinical Psychologist
Primary
0810007248
VA

Other

Enumeration date
11/08/2019
Last updated
01/10/2021
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