| Doctor Name: | RANDY L DRAKE |
| NPI Number: | 1174645493 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MHC |
| License Number: | 010158 |
| Business Practice Address: | 206 Ne 2nd St Leon, IA - 501441614 |
| Business Phone Number: | 6414467600 |
| Business Fax Number: | 6414467600 |
| Mailing Address: | 206 Ne 2nd St, LEON |
| State: | IA |
| Postal Code: | 501441614 |
| Phone Number: | 6414467600 |
| Fax Number: | 6414467600 |
| NPI Enumeration Date: | 04/06/2007 |
| NPI Last Update Date: | 02/06/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 010158 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |