Individual
RANDI PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
27TH SPECIAL OPERATIONS MEDICAL GROUP, 224 W D. L. INGRAM AVENUE, BLDG. 1408, CANNON AFB, NM 88103
(815) 644-0202
Mailing address
232 WILMINGTON CIR, CLOVIS, NM 88101-9395
(815) 644-0202
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.015731
IL
Other
Enumeration date
09/15/2015
Last updated
11/05/2024
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