Individual
RANDALL CALLAWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S., MFT
Contact information
Practice address
5584 S FORT APACHE RD, LAS VEGAS, NV 89148-7657
(702) 743-3305
Mailing address
5584 S FORT APACHE RD, LAS VEGAS, NV 89148-7657
(702) 743-3305
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346679685
—
NV
Enumeration date
11/07/2013
Last updated
01/26/2024
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