Individual
MRS. CHRISTINE RANDLE
Active
Individual
MRS. CHRISTINE RANDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
111274
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05420331
UBH
MA
01
—
1035290
FALLON
MA
01
—
11602293
CAQH
—
05
—
1852892
—
MA
01
—
MAGELLAN
411712
MA
01
—
P08211
BCBS
MA
Enumeration date
09/26/2006
Last updated
07/08/2007
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