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Individual

QUILNINIOUS RANDALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3313 WASHINGTON ST, BOSTON, MA 02130-2691
(508) 789-2365
Mailing address
3313 WASHINGTON ST, BOSTON, MA 02130-2691
(508) 789-2365

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
251E00000X
Home Health Agency

Other

Enumeration date
07/18/2016
Last updated
07/18/2016
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