Individual
PAUL STILES RANDAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
850 E 9400 S STE 103, SANDY, UT 84094-4104
(801) 450-0199
(888) 503-2513
Mailing address
2560 E WOODCHUCK WAY, SANDY, UT 84093-2813
(801) 450-0199
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
376787-6006
UT
101YM0800X
Mental Health Counselor
Primary
376787-3902
UT
101YM0800X
Mental Health Counselor
376787-3904
UT
Other
Enumeration date
05/09/2018
Last updated
10/20/2019
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