Individual
MR. RANDI MAURICE LABROUSSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS-CADC 1
Contact information
Practice address
1776 MEADOWLARK DR NE, KEIZER, OR 97303-1951
(503) 400-1440
Mailing address
1776 MEADOWLARK DR NE, KEIZER, OR 97303-1951
(503) 400-1440
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
95-10-29
OR
104100000X
Social Worker
—
—
Other
Enumeration date
08/30/2013
Last updated
08/30/2013
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