Individual
TERRY RANDOLPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., LPC
Contact information
Practice address
1161 N EL DORADO PL, TUCSON, AZ 85715-4607
(520) 748-7108
Mailing address
1161 N EL DORADO PL, TUCSON, AZ 85715-4607
(520) 748-7108
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
BH3625
AZ
Other
Enumeration date
10/16/2013
Last updated
10/16/2013
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