| NPI | 1033667936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA ELIZABETH RANDOLPH Sole Proprietor 804-241-2324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904009394) |
| Enumeration Date | 2016-09-20 |
| Last Update Date | 2016-09-20 |