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Individual

RANDAL SCOTT NEARY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
50258 VAN DYKE AVE, SHELBY TWP, MI 48317-1374
(586) 884-4717
Mailing address
8515 GERHARDT ST, SHELBY TOWNSHIP, MI 48317-4411
(588) 246-4749

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
640116816
MI

Other

Enumeration date
11/08/2018
Last updated
11/08/2018
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