Individual
MRS. ANITA RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPS/MHSP
Contact information
Practice address
511 8TH ST, CLARKSVILLE, TN 37040-3093
(931) 920-7200
Mailing address
511 8TH ST, CLARKSVILLE, TN 37040-3093
(931) 920-7200
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
03/01/2007
Last updated
11/25/2013
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