Individual
ANA ELVIRA RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LCMHCA
Contact information
Practice address
1428 ELLEN ST STE B, MONROE, NC 28112-5286
(704) 438-9901
Mailing address
8024 LAKE PROVIDENCE DR, WEDDINGTON, NC 28104-6225
(909) 979-7443
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A16203
NC
103TC1900X
Counseling Psychologist
A16203
NC
Other
Enumeration date
03/09/2021
Last updated
03/11/2021
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