Individual
RANDALL VERHDEK OFTEDAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
744 PARK AVE, CRANSTON, RI 02910-2150
(401) 338-7277
Mailing address
744 PARK AVE, CRANSTON, RI 02910-2150
(401) 338-7277
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
ISW01913
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RO53435
—
RI
Enumeration date
12/20/2007
Last updated
12/09/2008
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