Individual
CHERLA LADAWN RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
540 3RD ST, IDAHO FALLS, ID 83401-3953
(208) 524-5607
(208) 524-0636
Mailing address
540 3RD ST, IDAHO FALLS, ID 83401-3953
(208) 524-5607
(208) 524-0636
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
10/14/2019
Last updated
10/14/2019
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