Individual
SHANICE MONIQUE RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
14202 WATER FOWL WAY, UPPER MARLBORO, MD 20774-4002
(301) 257-6282
Mailing address
14202 WATER FOWL WAY, UPPER MARLBORO, MD 20774-4002
(301) 257-6282
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
23077
MD
Other
Enumeration date
10/05/2020
Last updated
10/05/2020
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