Individual
RANDALL LEE OTTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
250 POND ST, BRAINTREE, MA 02184-5351
(781) 348-3904
(781) 848-1245
Mailing address
250 POND ST, BRAINTREE, MA 02184-5351
(781) 348-3904
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6165
MA
Other
Enumeration date
09/16/2006
Last updated
07/14/2010
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