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Individual
MR. RANDALL E GENOW II
Active
Individual
MR. RANDALL E GENOW II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LMSW, CAADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
L283307
MI
101YM0800X
Mental Health Counselor
L283307
MI
1041C0700X
Clinical Social Worker
Primary
L283307
MI
Other
Enumeration date
08/08/2013
Last updated
12/21/2018
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