Individual
NICHOLE M RANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS, MA
Contact information
Practice address
4000 W SPENCER ST, APPLETON, WI 54914-4015
(920) 735-9010
(920) 735-9050
Mailing address
4000 W SPENCER ST, APPLETON, WI 54914-4015
(920) 735-9010
(920) 735-9050
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/10/2008
Last updated
09/10/2008
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