Individual
KHARA J.B. RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1158 PROFESSIONAL DR STE N, WILLIAMSBURG, VA 23185-6618
(207) 852-1889
Mailing address
1158 PROFESSIONAL DR STE N, WILLIAMSBURG, VA 23185-6618
(207) 852-1889
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0710102738
VA
101YP2500X
Professional Counselor
Primary
0701005512
VA
101YP2500X
Professional Counselor
CC5102
ME
Other
Enumeration date
06/24/2014
Last updated
09/09/2019
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