Individual
LISA RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
690 E WARNER RD STE 115, GILBERT, AZ 85296-3056
(480) 444-2434
Mailing address
4122 E MCLELLAN RD, UNIT 1, MESA, AZ 85205-3107
(480) 688-8282
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/11/2015
Last updated
08/11/2015
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