Individual
HEATHER JEAN RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
709 UNIVERSITY AVE W, SAINT PAUL, MN 55104-4804
(651) 227-8471
(651) 265-2355
Mailing address
709 UNIVERSITY AVE W, SAINT PAUL, MN 55104-4804
(651) 227-8471
(651) 265-2355
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
8634
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8634
MN DEPT OF HEALTH- SLP LICENSE
MN
Enumeration date
11/01/2011
Last updated
11/01/2011
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