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Individual

BYRON RANDALL JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CPRP

Contact information

Practice address
6340 SECURITY BLVD, GWYNN OAK, MD 21207-5173
(410) 912-4460
Mailing address
6340 SECURITY BLVD STE B34, GWYNN OAK, MD 21207-5173
(443) 912-4460

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
05/02/2021
Last updated
10/26/2021
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