Individual
DONTE RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CADCII
Contact information
Practice address
640 OAKMONT HL, DULUTH, GA 30097-5744
(678) 488-9562
Mailing address
640 OAKMONT HL, DULUTH, GA 30097-5744
(678) 488-9562
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0590
GA
Other
Enumeration date
05/11/2023
Last updated
05/11/2023
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