Individual
MR. BRYAN J RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
2274 MOUNT MOOSILAUKE HWY, PIKE, NH 03780-5615
(603) 989-3500
Mailing address
PO BOX 175, HAVERHILL, NH 03765-0175
(603) 989-3500
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1894
NH
Other
Enumeration date
01/28/2016
Last updated
01/28/2016
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