Individual
ALANNA M RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
38 W CHURCH ST, FAIRPORT, NY 14450-2130
(585) 421-2015
(585) 421-2024
Mailing address
38 W CHURCH ST, FAIRPORT, NY 14450-2130
(585) 421-2015
(585) 421-2024
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
012314-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30-0213081
TAX ID
NY
Enumeration date
10/03/2006
Last updated
06/18/2015
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