Individual
SHELBI L RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
60 W SUNBRIDGE DR, FAYETTEVILLE, AR 72703-1822
(479) 695-1240
(479) 695-1242
Mailing address
1968 HIGHWAY 31 N, BEEBE, AR 72012-9784
(512) 718-8517
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A2407009
AR
Other
Enumeration date
08/02/2024
Last updated
08/02/2024
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