Healthcare Provider Details

I. General information

NPI: 1497482491
Provider Name (Legal Business Name): RANDI TOLMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RANDI BATES

II. Dates (important events)

Enumeration Date: 08/01/2022
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12401 S 450 E UNIT D2A
DRAPER UT
84020-7938
US

IV. Provider business mailing address

3761 N TUMWATER WEST DR
EAGLE MOUNTAIN UT
84005-6167
US

V. Phone/Fax

Practice location:
  • Phone: 685-180-1277
  • Fax:
Mailing address:
  • Phone: 801-895-5926
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number14280274-3501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: