IVONNE CARMEN RANDOLPH

PORT ORANGE, FL
NPI1922148451
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: FL  sa 1206)
Additional Taxonomies252Y00000X Early Intervention Provider Agency
Enumeration Date2007-02-07
Last Update Date2020-10-15
Business Address
Mrs. IVONNE CARMEN RANDOLPH MACCCSLP
5791 FALLING TREE LN
PORT ORANGE, FL 32127-7993
Phone number: 407-595-2710
Mailing Address
Mrs. IVONNE CARMEN RANDOLPH MACCCSLP
5791 FALLING TREE LN
PORT ORANGE, FL 32127-7993
Phone number: 407-595-2710