Randolph, Leah Susan
Randolph, Leah Susan is an sole proprietor health care provider with primary practice located at 21 Waumbeck St , Dorchester MA 02121-1220. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Randolph, Leah Susan can be contacted via phone (617) 291-3623.Contact Information
Primary practice address
21 Waumbeck St
Dorchester MA 02121-1220
Phone: (617) 291-3623
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X |
Profile Details
| NPI number | 1194034835 |
|---|---|
| LBN Legal business name | Randolph, Leah Susan |
| Credentials | LADC I, MM |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 29th, 2010 |
| Last updated | Sep 29th, 2010 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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