Individual
AMY J RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
10016 N ORCHARD LN, SPOKANE, WA 99208-5522
(509) 981-2147
Mailing address
10016 N ORCHARD LN, SPOKANE, WA 99208-5522
(509) 981-2147
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-21-53656
BEHAVIOR ANALYST CERTIFICATION BOARD
—
Enumeration date
02/08/2022
Last updated
02/08/2022
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