Daut, Randall L

Daut, Randall L is an individual health care provider with primary practice located at 509 Mcmillen St , Fort Atkinson WI 53538-1263. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Health Service. Behavioral Health & Social Service Providers / Psychologist is his primary health care specialty. Daut, Randall L can be contacted via phone (920) 563-7995.

Contact Information

Primary practice address
509 Mcmillen St Fort Atkinson WI 53538-1263
Phone: (920) 563-7995
Fax: (920) 568-6047
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 801-057 Wisconsin
Behavioral Health & Social Service Providers / Health Service 103TH0100X 801-057 Wisconsin

Profile Details

NPI number 1568493500
LBN Legal business name Daut, Randall L
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 6th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568493500 NPPES
Wisconsin MEDICAID 39025900

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