Provider Information for 1750479523
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Mr. RANDALL S. WEEKS LPC, BC-TMH
Sex: Male
NPI: 1750479523
Last Updated: 2020-10-30
Certification Date: 2020-10-30
Certification Date: 2020-10-30
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1750479523 | ||||||||
| Enumeration Date | 2006-10-10 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 10 PRIVATE ROAD 3151 APARTMENT 6 OXFORD, MS 38655 United States Phone: 662-458-9740 | Fax: | ||||||||
| Primary Practice Address | 2690 WEST OXFORD LOOP, SUITE 146 OXFORD, MS 38655 United States Phone: 662-458-9740 | Fax: | ||||||||
| Secondary Practice Address(es) | 303 W PARK AVE | ||||||||
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