Provider Demographics
NPI:1477792042
Name:GARLAND, RANDALL J (PHD)
Entity Type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:J
Last Name:GARLAND
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 N CAMPBELL AVE
Mailing Address - Street 2:#5
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-2357
Mailing Address - Country:US
Mailing Address - Phone:520-322-9334
Mailing Address - Fax:
Practice Address - Street 1:3333 N CAMPBELL AVE
Practice Address - Street 2:#5
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-2357
Practice Address - Country:US
Practice Address - Phone:520-322-9334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-05
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2029103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical