Individual
KATHLEEN T RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC, EMDR
Contact information
Practice address
300 W MAIN ST, NORTHBOROUGH, MA 01532-2132
(508) 351-6511
Mailing address
PO BOX 439, NORTHBOROUGH, MA 01532-0439
(508) 351-6511
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
367
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LM0896
BLUE CROSS/BLUE SHIELD
MA
Enumeration date
10/17/2006
Last updated
07/08/2007
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