Individual
RANDALL J GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
RR 2 BOX 132G, MADILL, OK 73446-8445
(580) 677-9822
Mailing address
RR 2 BOX 132G, MADILL, OK 73446-8445
(580) 677-2949
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
05/07/2007
Last updated
07/26/2007
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