Individual
MIRIAM SC RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCA
Contact information
Practice address
14 SYCAMORE WAY, BRANFORD, CT 06405-6551
(203) 483-2630
Mailing address
20 HOMESTEAD PL, BRANFORD, CT 06405-2603
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
7352
CT
Other
Enumeration date
10/09/2024
Last updated
10/09/2024
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