Individual
WENDY RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
211 CHURCH ST, SARATOGA SPGS, NY 12866-1003
(518) 583-8405
(518) 583-8463
Mailing address
756 MAIN ST, CORINTH, NY 12822-2204
(518) 588-8743
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F402463-1
NY
Other
Enumeration date
08/07/2018
Last updated
08/07/2018
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