Individual
GERALD RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CHW
Contact information
Practice address
28 HARDING ST, MIDDLEBORO, MA 02346-1014
(321) 368-2142
Mailing address
68 HARRISON AVE # 40649368, BOSTON, MA 02111-1929
(833) 427-6739
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
CHW5204
MA
Other
Enumeration date
01/28/2025
Last updated
05/08/2025
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