MEDICARE: RANDEE ROXANN TOMLINSON M.S., LMFT

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
1	106H00000X	Marriage & Family Therapist	863	OK

General Provider Information

NPI Number	:	1851431340
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RANDEE ROXANN TOMLINSON M.S., LMFT

Provider Business Mailing Address
First Line	:	2219 SHADOWRIDGE CT
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73159-7530
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2219 SHADOWRIDGE CT
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73159-7530
Country	:	US
Telephone Number	:	405-823-5347
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2007
Last Update Date	:	11/05/2015

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