Individual
ANDREA RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
915 PLEASANT ST, WORCESTER, MA 01602-1908
(508) 612-0566
Mailing address
915 PLEASANT ST, WORCESTER, MA 01602-1908
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
13497
MA
Other
Enumeration date
07/19/2023
Last updated
07/19/2023
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