Individual
SHANDY LYNN RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
2221 RIO GRANDE BLVD NW, ALBUQUERQUE, NM 87104-2529
(505) 459-2695
Mailing address
224 CAMINO DOS SW, ALBUQUERQUE, NM 87105
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
X-10227
NM
Other
Enumeration date
08/28/2017
Last updated
08/28/2017
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