Individual
HEATHER RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
10255 LAMBERT RD, PEYTON, CO 80831-3800
(719) 495-5520
Mailing address
10323 ROSS LAKE DR, PEYTON, CO 80831-8441
(478) 319-1120
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
24433858
CO
235Z00000X
Speech-Language Pathologist
SLP006967
GA
Other
Enumeration date
01/04/2009
Last updated
01/02/2024
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