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Individual

LESLEY RANDALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
6017 N PONDEROSA WAY, PARKER, CO 80134-5522
(303) 841-1680
Mailing address
6017 N PONDEROSA WAY, PARKER, CO 80134-5522
(303) 841-1680

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12037584
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
COTP129591A
CO
Enumeration date
03/27/2007
Last updated
07/08/2007
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