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General NPI Number Information
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NPI Number | 1366394728
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Entity Type | Individual
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Provider Name | VIRGINIA RANDALL
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Gender |
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Dates
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Enumeration Date | 02/10/2026
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 1200 SALISBURY RD
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City | MOCKSVILLE
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State | NC
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Zip | 27028-9302
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Country | US
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Telephone | 336-751-5921
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Fax |
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Provider Business Mailing Address
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Address Line | 177 W KINDERTON WAY APT 203
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City | ADVANCE
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State | NC
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Zip | 27006-7393
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State |
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