Russ, Randolph Graham

Russ, Randolph Graham is an sole proprietor health care provider with primary practice located at 2190 Sunderland Ave , Wellington FL 33414-7722. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Russ, Randolph Graham can be contacted via phone (561) 201-7180.

Contact Information

Primary practice address
2190 Sunderland Ave Wellington FL 33414-7722
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X MH0002620 Florida

Profile Details

NPI number 1437326873
LBN Legal business name Russ, Randolph Graham
Credentials Master of Arts (MA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 14th, 2008
Last updated Apr 24th, 2009 - about 17 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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