person
Mark Hampton Randolph, CSAC,CSIT,LADC
Addiction (Substance Use Disorder) Counselor in Hudson, Wisconsin
NPI 1689454084

Mark Hampton Randolph is an Addiction (Substance Use Disorder) Counselor based in Hudson, WI and is specialized in Addiction (Substance Use Disorder). Mark Hampton Randolph practices in Hudson, WI and has the professional credentials of CSAC,CSIT,LADC. The NPI Number for Mark Hampton Randolph is 1689454084 and holds a License No. 16008-132 (Wisconsin).

The current practice location address for Mark Hampton Randolph is 405 Stageline Rd, Hudson, WI and can be reached out via phone at 715-531-6210 and via fax at 715-531-6755.

Location: 405 Stageline Rd, Hudson, WI, 54016-1793
person
Provider Profile Details
NPI Number
1689454084
Provider Name
Mark Hampton Randolph
Credential
CSAC,CSIT,LADC
Provider Entity Type
Individual
Gender
Male
Address
405 Stageline Rd, Hudson, WI, 54016-1793
Phone Number
715-531-6210
Fax Number
715-531-6755
Provider Enumeration Date
10/03/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
405 Stageline Rd
City
State
Zip
54016-1793
Phone Number
715-531-6210
Fax Number
715-531-6755
person
Provider Business Mailing Address Details
Address
405 Stageline Rd
City
State
Zip
54016-1793
Phone Number
715-531-6210
Fax Number
715-531-6755
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
16008-132 (Wisconsin)
Definition
Definition to come...
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