Individual
KAREN RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5 BROWN AVE, WESTON, WV 26452-2177
(304) 269-3923
(304) 269-9733
Mailing address
5 BROWN AVE, WESTON, WV 26452-2177
(304) 269-3923
(304) 269-9733
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
454
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
236407
MHN
WV
01
—
383056
MAMSI
WV
01
—
4318099
AETNA
WV
01
—
Y502969
HEALTH PLAN
WV
Enumeration date
09/16/2006
Last updated
07/08/2007
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