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Individual

MR. JOSEPH BRANNON RANDOLPH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MS, MBA, LPC

Contact information

Practice address
6801 ISAACS ORCHARD RD, STE. 215, SPRINGDALE, AR 72762-6545
(479) 725-3813
(479) 419-4046
Mailing address
6801 ISAACS ORCHARD RD, STE. 215, SPRINGDALE, AR 72762-6545
(479) 725-3813
(479) 419-4046

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PO309038
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
181106719
AR
Enumeration date
06/13/2007
Last updated
11/25/2013
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