Individual
TELETHIA RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7420 E 35TH ST, INDIANAPOLIS, IN 46226-5880
(317) 599-9821
Mailing address
7420 E 35TH ST, INDIANAPOLIS, IN 46226-5880
(317) 599-9821
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
—
—
372600000X
Adult Companion
—
—
3747A0650X
Attendant Care Provider
—
—
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
06/29/2020
Last updated
06/29/2020
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