Individual
DR. JOHN L RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ED.D.
Contact information
Practice address
43 STARBIRD ST., MALDEN, MA 02148-2835
(781) 321-6424
Mailing address
150 S HUNTINGTON AVE, BOSTON VAMC, BOSTON, MA 02130-4817
(857) 364-3626
(857) 364-4484
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3875
MA
103TC1900X
Counseling Psychologist
3875
MA
Other
Enumeration date
09/25/2006
Last updated
07/11/2012
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