MR. Bryan J Randolph, LICSW
NPI #1639536147 in Pike, New Hampshire
Provider Information
- NPI Number
- 1639536147
- Entity Type
- Individual
- Name
- MR. Bryan J Randolph, LICSW
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Social Worker - Clinical
- Credential
- LICSW
- Enumeration Date
- Jan 28, 2016
- Last Updated
- Jan 28, 2016
Practice Location
- Address
- 2274 MOUNT MOOSILAUKE HWY
- City
- Pike
- State
- New Hampshire
- ZIP Code
- 03780-5615
- Phone
- (603) 989-3500
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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