Organization
FAITH FAMILY DEVELOPMENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDY DUANE RANDLEMAN PH.D. (PSYCHOLOGIST)
(918) 452-3512
Entity
Organization
Contact information
Practice address
RR 1 BOX 131C, EUFAULA, OK 74432-9223
(918) 452-3512
(918) 452-3512
Mailing address
RR 1 BOX 131C, EUFAULA, OK 74432-9223
(918) 452-3512
(918) 452-3512
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
825
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100839240-A
—
OK
05
—
200097840-A
—
OK
05
—
200097840-B
—
OK
Enumeration date
09/23/2009
Last updated
09/23/2009
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