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General NPI Number Information
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NPI Number | 1043048739
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Entity Type | Individual
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Provider Name | BRIGID MARY RANDA MFT, PH.D CANDIDATE
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Gender | Female
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Dates
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Enumeration Date | 07/24/2024
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Last Update Date | 07/24/2024
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Provider Practice Location Address
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Address Line | 676 FUTENMA
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City | GINOWAN
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State | OKINAWA
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Zip | 96362
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Country | JP
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Telephone | 98-971-9355
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Fax |
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Provider Business Mailing Address
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Address Line | PSC 482 BOX 2478
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City | FPO
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State | AP
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Zip | 96362-0025
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Country | US
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Telephone | 804-185-8496
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State | WI
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