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NPI Code Detail

MEDICARE: ELLA RANDOLPH

MEDICARE: ELLA RANDOLPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1245186790
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLA RANDOLPH
Provider Business Mailing Address
First Line : 1018 LARAMIE ST
Second Line :
City : MANHATTAN
State : KS
Zip : 66502-5310
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9912 LAVENDER LN
Second Line :
City : MANHATTAN
State : KS
Zip : 66502-1531
Country : US
Telephone Number : 785-370-6460
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2026
Last Update Date : 03/07/2026

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Directions to “ ELLA RANDOLPH ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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