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Individual

RANDALL ZUNI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CPSW,BSN

Contact information

Practice address
650 VANDENBOSCH PKWY, GALLUP, NM 87301-5508
(505) 726-6919
(505) 726-6937
Mailing address
650 VANDENBOSCH PKWY, GALLUP, NM 87301-5508
(505) 726-6919
(505) 726-6937

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
1050
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1050
CERTIFIED PEER SUPPORT WORKER
NM
Enumeration date
02/28/2020
Last updated
02/28/2020
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