Provider Demographics
NPI:1255472213
Name:HARPER, RANDOLPH THOMAS (PH D)
Entity Type:Individual
Prefix:DR
First Name:RANDOLPH
Middle Name:THOMAS
Last Name:HARPER
Suffix:
Gender:M
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 ANTONINE ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-3601
Mailing Address - Country:US
Mailing Address - Phone:504-895-6068
Mailing Address - Fax:504-891-3039
Practice Address - Street 1:1305 ANTONINE ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3601
Practice Address - Country:US
Practice Address - Phone:504-895-6068
Practice Address - Fax:504-891-3039
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA180103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical