Individual
MISS DELISA RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
233 SANDS ST APT 14B, BROOKLYN, NY 11201-1576
(917) 504-5332
Mailing address
233 SANDS ST APT 14B, BROOKLYN, NY 11201-1576
(917) 504-5332
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
09/12/2022
Last updated
09/12/2022
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