Individual
GARRETT A RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.C.S.W.
Contact information
Practice address
163 FOREST AVE, ORONO, ME 04473
(207) 356-1622
Mailing address
163 FOREST AVE, ORONO, ME 04473-4723
(207) 356-1622
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC16749
ME
Other
Enumeration date
11/02/2017
Last updated
01/05/2024
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