Individual
RANDALL CHEESEBOROUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
21 OLD ROUTE 6, CARMEL, NY 10512-2107
(845) 225-5202
Mailing address
57 MIDDLE AVE, SHELTON, CT 06484-3949
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
22275
NY
Other
Enumeration date
06/15/2021
Last updated
04/29/2024
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