RANDOLPH OUTLAW

BROOKLYN, NY
NPI1669522256
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NY  11554)
Enumeration Date2007-01-12
Last Update Date2007-07-08
Business Address
-- RANDOLPH OUTLAW CASAC
2857 W 8TH ST
BROOKLYN, NY 11224-3604
Phone number: 718-265-4200
Mailing Address
-- RANDOLPH OUTLAW CASAC
2857 W 8TH ST
BROOKLYN, NY 11224-3604
Phone number: 718-265-4200
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