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Individual

RANDALL KLOTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPCC

Contact information

Practice address
115 ROCKWOOD LN, HAZARD, KY 41701-9415
(606) 436-5761
Mailing address
115 ROCKWOOD LN, HAZARD, KY 41701-9415

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
0180
KY
101YP2500X
Professional Counselor
Primary
104182
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30612022
KY
05
7100290320
KY
Enumeration date
06/07/2006
Last updated
03/30/2018
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