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Contact Information

MARQUE E RANDALL, PHD
1300 N 200 E
STE 114-A
LOGAN, UT84341-2398
 Phone: 435-753-2687
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Counseling

103TC1900X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for MARQUE E RANDALL · (Male)

NPI # 1457371189
Status Active
Credentials PHD
Entity Individual
Enumeration date 07/19/2006
Last updated 08/31/2007 - About 19 years ago
Sole proprietor 1 Yes
Identifiers
  • UT License # 52285242501
  • UT Other 52285242501001 BCBS
  • UT Other 885077 DMBA
  • UT Other 107019240103 IHC
  • UT Other 85006 PEHP
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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