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Individual

JAYME T RANDLE SR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CDCA

Contact information

Practice address
1680 NAVE RD SE, MASSILLON, OH 44646-9604
(330) 837-9411
(330) 837-4603
Mailing address
625 CLEVELAND AVE NW, CANTON, OH 44702-1805
(330) 455-0374
(330) 453-6716

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.177447
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0372358
OH
Enumeration date
09/27/2019
Last updated
09/24/2021
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