Individual
AMANDA MARIE RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
81 WINDSOR BLVD, COLUMBUS, MS 39702-3143
(662) 329-0050
(601) 607-1358
Mailing address
711 AVIGNON DR, RIDGELAND, MS 39157-5120
(601) 605-6777
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S4447
MS
Other
Enumeration date
07/03/2018
Last updated
07/03/2018
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