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1962537100
RANDOLF REGAN
BALTIMORE, MD
NPI
1962537100
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MD AC0043)
Enumeration Date
2007-02-21
Last Update Date
2007-07-08
Business Address
Mr. RANDOLF REGAN CAC-AD
9100 FRANKLIN SQUARE DR EATP
BALTIMORE, MD 21237-3903
Phone number: 410-887-6465
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Mailing Address
Mr. RANDOLF REGAN CAC-AD
23 N BERNICE AVE
BALTIMORE, MD 21229-3712
Phone number: 410-967-0169
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