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Individual

MS. RANDI BETH LIGHT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS

Contact information

Practice address
2005 VALPARAISO ST, SUITE 209, VALPARAISO, IN 46383-3329
(219) 252-5464
(219) 728-1860
Mailing address
37 SHORE DR, PORTAGE, IN 46368-1008
(219) 929-8726
(219) 728-1860

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Enumeration date
05/16/2016
Last updated
05/16/2016
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