MICHAEL RANDOLPH

ROSEBURG, OR
NPI1144010653
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
Additional Taxonomies101YM0800X Counselor, Mental Health
Enumeration Date2025-05-08
Last Update Date2026-10-05
Business Address
MICHAEL RANDOLPH
548 SE JACKSON ST
ROSEBURG, OR 97470-4983
Phone number: 541-440-3532
Mailing Address
MICHAEL RANDOLPH
PO BOX 1121
ROSEBURG, OR 97470-0254
Phone number: 541-672-2691
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