Provider Demographics
NPI:1073844742
Name:THUESEN, RANDALL E (MA)
Entity Type:Individual
Prefix:
First Name:RANDALL
Middle Name:E
Last Name:THUESEN
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 COURT HOUSE SQ
Mailing Address - Street 2:
Mailing Address - City:NEW MADRID
Mailing Address - State:MO
Mailing Address - Zip Code:63869-1761
Mailing Address - Country:US
Mailing Address - Phone:573-748-7900
Mailing Address - Fax:573-748-7991
Practice Address - Street 1:1 COURT HOUSE SQ
Practice Address - Street 2:
Practice Address - City:NEW MADRID
Practice Address - State:MO
Practice Address - Zip Code:63869-1761
Practice Address - Country:US
Practice Address - Phone:573-748-7900
Practice Address - Fax:573-748-7991
Is Sole Proprietor?:No
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)