Individual
MR. RANDLE BLAKE GANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
3701 LOOP RD, TUSCALOOSA, AL 35404-5015
(205) 554-2000
Mailing address
8751 HARDING DR, COTTONDALE, AL 35453-1311
(205) 826-2127
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
3279G
AL
Other
Enumeration date
04/17/2023
Last updated
04/17/2023
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