Individual
MR. RANDY JAY THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
935 S OREM BLVD, OREM, UT 84058
(801) 903-5903
Mailing address
935 S OREM BLVD, OREM, UT 84058-5011
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5026157-3501
UT
Other
Enumeration date
02/04/2019
Last updated
02/04/2019
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