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Individual
PAUL STILES RANDAK
Active
Individual
PAUL STILES RANDAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
376787-6006
UT
101YM0800X
Mental Health Counselor
Primary
376787-3902
UT
101YM0800X
Mental Health Counselor
376787-3904
UT
Other
Enumeration date
05/09/2018
Last updated
10/20/2019
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