Organization
FIRST STEP PEDIATRIC PSYCHOLOGY CONSULTANTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIFFANY GILMORE RANDELL PSY.D. (CEO/LICENSED PSYCHOLOGIST)
(678) 462-5478
Entity
Organization
Contact information
Practice address
1415 HIGHWAY 85 N STE 310-222, FAYETTEVILLE, GA 30214-7738
(678) 462-5478
Mailing address
1415 HIGHWAY 85 N STE 310-222, FAYETTEVILLE, GA 30214-7738
(678) 462-5478
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
PY003365
GA
Other
Enumeration date
05/26/2010
Last updated
05/26/2010
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