Korell, Randi Jo
Korell, Randi Jo is an individual health care provider with primary practice located at 113 N Commercial , Emmett ID 83617. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Korell, Randi Jo can be contacted via phone (208) 398-8473.Contact Information
Primary practice address
113 N Commercial
Emmett ID 83617
Phone: (208) 398-8473
Fax: (208) 398-8311
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 359 | Idaho |
Profile Details
| NPI number | 1073641510 |
|---|---|
| LBN Legal business name | Korell, Randi Jo |
| Credentials | MS LCPC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 28th, 2007 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073641510 | NPPES |
| Idaho | Other | 000010152108 | BLUE SHIELD |
| Idaho | Other | Q7486 | BLUE SHIELD |
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