Individual
MR. JEFFERY ALLEN RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2360 E PERSHING BLVD, CHEYENNE, WY 82001-5356
(307) 778-7550
(307) 778-7393
Mailing address
2360 E PERSHING BLVD, CHEYENNE, WY 82001-5356
(307) 778-7550
(307) 778-7393
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-1073
WY
Other
Enumeration date
09/13/2018
Last updated
09/13/2018
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