Individual
RANDALL KEITH SOUTHERN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
EDD, LPC
Contact information
Practice address
115 MANNING DR SW STE A202, HUNTSVILLE, AL 35801-4341
(256) 489-0046
Mailing address
115 MANNING DR SW STE A202, HUNTSVILLE, AL 35801-4341
(256) 489-0046
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1485
AL
Other
Enumeration date
08/24/2024
Last updated
08/24/2024
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