Individual
BRENDA MARIE RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
672 WELLWOOD AVE UNIT 2, LINDENHURST, NY 11757-1677
(631) 225-2623
Mailing address
642 SUNRISE HWY APT A, WEST BABYLON, NY 11704-6023
(631) 682-2243
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
032334
NY
Other
Enumeration date
01/08/2024
Last updated
01/08/2024
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