Tina Nicole Randolph, LISW
Social Worker, Clinical in Dover Afb, DE. Individual provider (NPI-1).
NPI number1780172973
StatusActive
Last updated in NPPESNov 30, 2021
Details
- NPI
- 1780172973
- Entity type
- Individual (NPI-1)
- Name
- Tina Nicole Randolph
- Credential
- LISW
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 24, 2018
- Certification date
- Nov 30, 2021
- Last updated
- Nov 30, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | I.2002316 | OH | Yes |
| 104100000X | Social Worker | 23300 | MD |
Practice location
300 Tuskegee BlvdDover Afb, DE 19902-5003
Phone 302-677-2674
Mailing address
300 Tuskegee BlvdDover Afb, DE 19902-5003
Phone 302-677-2674
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Other Clinical Social Worker providers in Dover Afb, DE
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