Individual
MS. ERICA RANDOLPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
121 TRUCK BYPASS RD, SILVER CITY, NM 88061-9202
(505) 919-9572
Mailing address
PO BOX 933, SILVER CITY, NM 88062-0933
(505) 919-9572
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0155861
NM
101YP2500X
Professional Counselor
0155861
NM
Other
Enumeration date
09/10/2009
Last updated
01/03/2020
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