Individual
KELLI RANDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14040 N CAVE CREEK RD STE 207, PHOENIX, AZ 85022-6179
(480) 203-5486
Mailing address
14040 N CAVE CREEK RD STE 207, PHOENIX, AZ 85022-6179
(602) 610-8250
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LAC-18009
AZ
Other
Enumeration date
08/18/2020
Last updated
08/18/2020
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