Individual
RANDY W PROUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10111 MARTIN LUTHER KING JR HWY STE 104, BOWIE, MD 20720-4225
(301) 327-1290
Mailing address
10111 MARTIN LUTHER KING JR HWY STE 104, BOWIE, MD 20720-4225
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/23/2022
Last updated
06/23/2022
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