Individual
MR. RANDY ERWIN MASTERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LPC
Contact information
Practice address
13 N BRIDGE ST STE A, SARANAC, MI 48881-5122
(616) 552-3463
Mailing address
95 SUMMIT ST, SARANAC, MI 48881-9533
(616) 550-6498
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401002718
MI
Other
Enumeration date
05/02/2011
Last updated
04/22/2021
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