Individual provider · Type 1 NPI
Mark Hampton Randolph, CSAC, CSIT, LADC
Addiction (Substance Use Disorder) Counselor · Hudson, WI
NPI number
1689454084
Active
Practice location
405 Stageline Rd
Hudson, WI 54016-1793
Fax (715) 531-6755
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 16008-132 (WI) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1689454084
Mark Hampton Randolph, CSAC, CSIT, LADC's National Provider Identifier is 1689454084, issued on Oct 3, 2023. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Hudson, WI. The record was last updated on Oct 3, 2023.