Individual
MS. AUTUMN RAIN RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHC-LP
Contact information
Practice address
6336 99TH ST, REGO PARK, NY 11374-1979
(718) 459-2558
(718) 770-7676
Mailing address
6336 99TH ST, REGO PARK, NY 11374-1979
(718) 459-2558
(718) 770-7676
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
P140191
NY
Other
Enumeration date
12/12/2025
Last updated
12/12/2025
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