Individual
JACOB C RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
311 S MADISON AVE, TULSA, OK 74120-3208
(918) 582-0061
Mailing address
1232 S NEW HAVEN AVE, TULSA, OK 74112-5130
(918) 382-3442
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
20301
OK
Other
Enumeration date
09/26/2025
Last updated
09/26/2025
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