Randolph, Dewayne
Randolph, Dewayne is an sole proprietor health care provider with primary practice located at 1005 Telegraph Station Ln , Glen Allen VA 23060-4006. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Pastoral, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Randolph, Dewayne can be contacted via phone (800) 648-9845.Contact Information
Primary practice address
1005 Telegraph Station Ln
Glen Allen VA 23060-4006
Phone: (800) 648-9845
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Pastoral | 101YP1600X | ||
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 0718000340 | Virginia |
Profile Details
| NPI number | 1851858237 |
|---|---|
| LBN Legal business name | Randolph, Dewayne |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 21st, 2019 |
| Last updated | Feb 21st, 2019 - about 6 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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