Individual
RAYMOND RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPSW
Contact information
Practice address
203 CALIFORNIA ST NE, ALBUQUERQUE, NM 87108-1802
(505) 206-0288
(505) 212-4229
Mailing address
203 CALIFORNIA ST NE, ALBUQUERQUE, NM 87108-1802
(505) 206-0288
(505) 212-4229
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
1921
NM
Other
Enumeration date
04/15/2026
Last updated
04/15/2026
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