Tiffany Gilmore Randell, Psy.D.
Psychologist, Clinical Child & Adolescent in Fayetteville, GA. Individual provider (NPI-1).
NPI number1245655893
StatusActive
Last updated in NPPESFeb 19, 2014
Details
- NPI
- 1245655893
- Entity type
- Individual (NPI-1)
- Name
- Tiffany Gilmore Randell
- Credential
- Psy.D.
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 19, 2014
- Last updated
- Feb 19, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC2200X | Psychologist, Clinical Child & Adolescent | PSY00365 | GA | Yes |
Practice location
101 Devant Street,Office 401
Fayetteville, GA 30214
Phone 404-585-5439 · Fax 678-802-0398
Mailing address
1415 Hwy 85 NSte 310-222
Fayetteville, GA 30214
Phone 404-585-5439 · Fax 678-802-0398
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