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Individual

MR. RANDOLPH IRVIN AUSTIN JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3819 HARBOR RD UNIT 103, CHESAPEAKE BEACH, MD 20732-3110
(410) 286-0547
(410) 286-8950
Mailing address
PO BOX 980, PRINCE FREDERICK, MD 20678-0980
(410) 535-3079
(410) 535-2220

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
MD

Other

Enumeration date
06/29/2017
Last updated
06/29/2017
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