Individual
KATHLEEN RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
2999 SUNSET BLVD, SUITE 100, WEST COLUMBIA, SC 29169-3496
(803) 939-9699
(803) 939-9086
Mailing address
6026 SYLVAN DR, COLUMBIA, SC 29206-1550
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6612
SC
Other
Enumeration date
07/02/2008
Last updated
07/15/2008
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