Individual
MARSHA E WALLS-RANDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6 N EUSTIS ST, EUSTIS, FL 32726-3408
(321) 276-5054
(888) 719-7820
Mailing address
12142 CITRUSWOOD DR, ORLANDO, FL 32832-5732
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SI5436
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
814454993
—
FL
Enumeration date
07/20/2022
Last updated
07/20/2022
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