Organization
RANDOLPH'S PROFESSIONAL TREATMENT SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH BRANNON RANDOLPH MBA, MS, LPC (PRESIDENT/CEO)
(479) 725-3813
Entity
Organization
Contact information
Practice address
6801 ISAACS ORCHARD RD, STE. 215, SPRINGDALE, AR 72762-6545
(479) 725-3813
(479) 419-4046
Mailing address
6801 ISAACS ORCHARD RD, STE. 215, SPRINGDALE, AR 72762-6545
(479) 725-3813
(479) 419-4046
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
P0309038
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181106719
—
AR
Enumeration date
04/23/2010
Last updated
12/10/2013
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