Individual
TOMI RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2901 HUNTERS TRL, PORTAGE, WI 53901-3403
(608) 742-5518
(608) 742-4087
Mailing address
2901 HUNTERS TRL, PORTAGE, WI 53901-3403
(608) 742-5518
(608) 742-4087
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
7117-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1710363031
—
WI
Enumeration date
08/10/2015
Last updated
10/15/2018
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