Individual
LYNETTE RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6770 S 900 E STE 105, MIDVALE, UT 84047-1710
(801) 305-3171
Mailing address
472 E 8TH AVE, SALT LAKE CITY, UT 84103-3151
(801) 906-1784
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12224267-3502
UT
Other
Enumeration date
06/29/2022
Last updated
06/29/2022
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