Individual
MARY CARMEN RANDLEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED., LPC
Contact information
Practice address
207 N OAK ST STE 5, SALLISAW, OK 74955-4602
(918) 724-6449
(918) 208-0687
Mailing address
PO BOX 1084, SALLISAW, OK 74955-1084
(918) 724-6449
(918) 208-0687
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
4855
OK
101YS0200X
School Counselor
—
—
103TS0200X
School Psychologist
229640
OK
106H00000X
Marriage & Family Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200378480
—
OK
05
—
200456660 A
—
OK
Enumeration date
06/24/2008
Last updated
09/29/2023
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