Individual
MR. RANDY JOE SMITH JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
160 SANDIA VIEW RD NW, ALBUQUERQUE, NM 87107-6022
(915) 200-9396
Mailing address
160 SANDIA VIEW RD NW, ALBUQUERQUE, NM 87107-6022
(915) 200-9396
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/05/2021
Last updated
04/05/2021
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