Individual
RANDY NAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW, LP
Contact information
Practice address
426 WEST AVE, RED WING, MN 55066-2473
(651) 385-6180
(651) 385-6195
Mailing address
426 WEST AVE, RED WING, MN 55066-2473
(651) 385-6180
(651) 385-6195
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP1609
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01013344
PREFERRED ONE
—
01
—
117956
U-CARE
—
05
—
247057800
—
MN
01
—
5115551
AETNA
—
01
—
61Q73NA
BX/BS
—
01
—
62-69127
MEDICA
—
01
—
855661013344
PREFERREDONE ADMINISTRATI
—
Enumeration date
05/24/2006
Last updated
09/11/2008
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