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Individual
RANDY ELY
Active
Individual
RANDY ELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RMHCI
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
IMHI7070
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IMH17070
FL HEALTH LICENSE
FL
Enumeration date
05/02/2018
Last updated
05/02/2018
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