Individual
MRS. JILL A RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
520 BURKARTH RD STE C, WARRENSBURG, MO 64093-3123
(203) 809-5274
Mailing address
605 W CULTON ST, WARRENSBURG, MO 64093-1517
(203) 809-5274
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2012012905
MO
Other
Enumeration date
05/18/2012
Last updated
05/18/2012
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