Individual
RENEE ELIZABETH BLIVEN RANDOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BCBA, LBA
Contact information
Practice address
324 SHIPPEETOWN RD, EAST GREENWICH, RI 02818-1118
(401) 529-3078
Mailing address
PO BOX 1117, EAST GREENWICH, RI 02818-0965
(401) 529-3078
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2015002575
MO
103K00000X
Behavior Analyst
LBA00081
RI
Other
Enumeration date
03/03/2015
Last updated
10/17/2016
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