Individual
JESSICA ANN RANDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDP
Contact information
Practice address
22 S THOR ST, SPOKANE, WA 99202-4855
(509) 533-2000
(509) 532-2005
Mailing address
22 S THOR ST, SPOKANE, WA 99202-4855
(509) 533-2000
(509) 532-2005
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60499946
WA
Other
Enumeration date
04/18/2018
Last updated
04/18/2018
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