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1689454084
MARK HAMPTON RANDOLPH
HUDSON, WI
NPI
1689454084
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI 16008-132)
Enumeration Date
2023-10-03
Last Update Date
2023-10-03
Business Address
MARK HAMPTON RANDOLPH CSAC, CSIT, LADC
405 STAGELINE RD
HUDSON, WI 54016-1793
Phone number: 715-531-6210
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Mailing Address
MARK HAMPTON RANDOLPH CSAC, CSIT, LADC
405 STAGELINE RD
HUDSON, WI 54016-1793
Phone number: 715-531-6210
Copy
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