Individual
RANDALL LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
6301 19TH AVE NW, MINOT, ND 58703-8899
(701) 852-3628
(701) 852-1190
Mailing address
PO BOX 5007, MINOT, ND 58702-5007
(701) 852-3628
(701) 852-1190
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1815
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
ND
Enumeration date
03/25/2019
Last updated
03/25/2019
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