Individual
DR. JOHN RANDALL BRANDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
3800 S NATIONAL AVE STE 770, SPRINGFIELD, MO 65807-5283
(417) 269-6891
(417) 269-5595
Mailing address
PO BOX 4046, SPRINGFIELD, MO 65808-4046
(417) 269-5712
(417) 269-7567
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2016032320
MO
103TC0700X
Clinical Psychologist
PY5269
FL
Other
Enumeration date
10/13/2016
Last updated
09/27/2019
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