Individual
MICHELLE RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, LBSW
Contact information
Practice address
2361 FAIRLANE DR, MONTGOMERY, AL 36116-1633
(334) 279-7830
(334) 277-8862
Mailing address
PO BOX 3223, 2014 UPPER WETUMPKA ROAD, MONTGOMERY, AL 36109-0223
(334) 279-7830
(334) 277-8862
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3477
AL
104100000X
Social Worker
1688B
AL
Other
Enumeration date
01/21/2016
Last updated
02/12/2016
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