Individual
MELINDA LUCILLE RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC LSW
Contact information
Practice address
115 O ST, SPARKS, NV 89431-3251
(775) 787-9411
(775) 787-9445
Mailing address
115 O ST, SPARKS, NV 89431-3251
(775) 787-9411
(775) 787-9445
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
703
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10
—
NV
Enumeration date
01/16/2013
Last updated
01/16/2013
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