Individual
MR. RON DEWAYNE RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MED LPC LMFT
Contact information
Practice address
2707 AIRPORT FREEWAY, SUITE 213, FORT WORTH, TX 76111-2370
(817) 920-9779
(817) 920-9553
Mailing address
3404 MARTIN LYDON, FORT WORTH, TX 76133-1419
(817) 927-5462
(817) 920-9553
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
5254
TX
106H00000X
Marriage & Family Therapist
3617
TX
Other
Enumeration date
09/16/2006
Last updated
04/24/2019
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