Individual
PROF. TRACIE MARIE RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
865 WOODSTOCK ROAD, VIRGINIA BEACH, VA 23464
(757) 348-2189
Mailing address
2085 LYNNHAVEN PKWY STE 106, VIRGINIA BEACH, VA 23456-1497
(757) 348-2189
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701012934
VA
Other
Enumeration date
08/31/2020
Last updated
10/13/2023
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