| Doctor Name: | DA'NEL E RANDALL |
| NPI Number: | 1043653090 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS, LPCC |
| License Number: | CC00579 |
| Business Practice Address: | 515 Bridge St Park Rapids, MN - 564701210 |
| Business Phone Number: | 2183669229 |
| Business Fax Number: | 2182372520 |
| Mailing Address: | 515 Bridge St E, PARK RAPIDS |
| State: | MN |
| Postal Code: | 56470 |
| Phone Number: | 2183669229 |
| Fax Number: | 2182372520 |
| NPI Enumeration Date: | 04/09/2013 |
| NPI Last Update Date: | 01/31/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | CC00579 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |