Individual
MR. TIM L RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
300 2ND AVE NE, SUITE 221, JAMESTOWN, ND 58401-3373
(701) 252-5398
(701) 252-5398
Mailing address
PO BOX 286, YPSILANTI, ND 58497-0286
(701) 489-3289
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1102
ND
Other
Enumeration date
06/28/2007
Last updated
07/08/2007
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