RANDALL BLAKE NEIDHART

ROSEBURG, OR
NPI1245791987
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2019-03-26
Last Update Date2021-03-03
Business Address
RANDALL BLAKE NEIDHART CADC
621 W MADRONE ST
ROSEBURG, OR 97470-3090
Phone number: 541-671-6838
Mailing Address
RANDALL BLAKE NEIDHART CADC
621 W MADRONE ST
ROSEBURG, OR 97470-3090
Phone number: 541-671-6838
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