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Individual
MR. RANDY LEROY COUSINEAU
Active
Individual
MR. RANDY LEROY COUSINEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CAADC, LPC, MLSW
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
6401001535
MI
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
206486
MI
104100000X
Social Worker
6801057570
MI
Other
Enumeration date
10/01/2012
Last updated
10/01/2012
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