Randall, Ethan
Randall, Ethan is an sole proprietor health care provider with primary practice located at 308 E Downing St , Tahlequah OK 74464-3014. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Randall, Ethan can be contacted via phone (918) 931-3995.Contact Information
Primary practice address
308 E Downing St
Tahlequah OK 74464-3014
Phone: (918) 931-3995
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 8189 | Oklahoma |
Profile Details
| NPI number | 1508526773 |
|---|---|
| LBN Legal business name | Randall, Ethan |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 29th, 2021 |
| Last updated | Jun 24th, 2024 - about 2 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.
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