Randolph Allen West, PSY D
Psychologist, Clinical in Shiprock, NM. Individual provider (NPI-1).
NPI number1073664512
StatusActive
Last updated in NPPESDec 28, 2016
Details
- NPI
- 1073664512
- Entity type
- Individual (NPI-1)
- Name
- Randolph Allen West
- Credential
- PSY D
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 12, 2007
- Last updated
- Dec 28, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | OS5398 | CA | Yes |
Practice location
Us Hwy 491 NorthShiprock, NM 87420
Phone 505-368-6001
Mailing address
Po Box 160Shiprock, NM 87420-0160
Phone 505-368-6001
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