Provider Information for 1568042869
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TONYA LEWIS RANDOLPH M. Ed, LPC
Sex: Female
NPI: 1568042869
Last Updated: 2021-04-11
Certification Date: 2021-04-11
Certification Date: 2021-04-11
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1568042869 | ||||||||||||
| Enumeration Date | 2021-04-11 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 308 AVENUE C KENTWOOD, LA 70444-2436 United States Phone: 985-514-1739 | Fax: | ||||||||||||
| Primary Practice Address | 308 AVENUE C KENTWOOD, LA 70444-2436 United States Phone: 985-514-1739 | Fax: | ||||||||||||
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