Individual
MRS. KATHLEEN MILLER RANDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
3800 N 91ST AVE, PHOENIX, AZ 85037-2368
(623) 772-2400
Mailing address
919 73RD ST, KENOSHA, WI 53143-5421
(262) 515-4690
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP10539
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42690900
—
WI
Enumeration date
04/24/2017
Last updated
04/24/2017
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