Individual
MR. RANDOLF REGAN SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CAC-AD
Contact information
Practice address
9100 FRANKLIN SQUARE DR, EATP, BALTIMORE, MD 21237-3903
(410) 887-6465
(410) 687-6005
Mailing address
23 N BERNICE AVE, BALTIMORE, MD 21229-3712
(410) 967-0169
(410) 687-6005
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
AC0043
MD
Other
Enumeration date
02/21/2007
Last updated
07/08/2007
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