Provider Demographics
NPI:1083045389
Name:REDMON, RANDI (MS, RMHCI)
Entity Type:Individual
Prefix:MS
First Name:RANDI
Middle Name:
Last Name:REDMON
Suffix:
Gender:F
Credentials:MS, RMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11460 N 53RD ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33617-2216
Mailing Address - Country:US
Mailing Address - Phone:813-304-2296
Mailing Address - Fax:
Practice Address - Street 1:11460 N 53RD ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33617-2216
Practice Address - Country:US
Practice Address - Phone:813-304-2296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-12
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH10734101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health