Individual
COLE RANDA; CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCDC-I
Contact information
Practice address
1619 CASTLE CT, HOUSTON, TX 77006-5707
(832) 609-0161
Mailing address
5803 SYLVAN GROVE DR, KINGWOOD, TX 77345-1786
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
45476
TX
Other
Enumeration date
03/29/2020
Last updated
03/29/2020
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