Individual
LISA RANDOLPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1110 CARROLL RD, PARAGOULD, AR 72450-6333
(870) 897-2372
Mailing address
1110 CARROLL RD, PARAGOULD, AR 72450-6333
(870) 897-2372
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/07/2025
Last updated
01/07/2025
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