Individual
MR. CARLIN RANDOLPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
762 QUINCY ST, BROOKLYN, NY 11221-2802
(917) 202-8615
Mailing address
762 QUINCY ST, BROOKLYN, NY 11221-2802
(917) 202-8615
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
464755101
NY
103K00000X
Behavior Analyst
613543122
NY
103K00000X
Behavior Analyst
Primary
918394151
NY
Other
Enumeration date
06/02/2015
Last updated
06/02/2015
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