| NPI | 1346447372 |
|---|---|
| Former Name | DIANNA L RANDLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OK 523) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OK 3552) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2007-07-08 |