Tia Randolph

NPI #1518599547 in Odenton, Maryland

Provider Information

NPI Number: 1518599547
Entity Type: Individual
Name: Tia Randolph
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Feb 7, 2020
Last Updated: Feb 7, 2020

Practice Location

Address: 2288 BLUE WATER BLVD STE 310
City: Odenton
State: Maryland
ZIP Code: 21113-3301
Phone: (410) 630-6936

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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