Individual
MS. LINDA LOU RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CACIII
Contact information
Practice address
803 W 4TH STREET, SUITE D, PUEBLO, CO 81003
(719) 225-8639
(719) 924-8299
Mailing address
803 W 4TH STREET, SUITE D, PUEBLO, CO 81003
(719) 225-8639
(719) 924-8299
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACC.0001001
CO
Other
Enumeration date
10/20/2017
Last updated
10/20/2017
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