| Doctor Name: | KATHLEEN T RANDALL |
| NPI Number: | 1003996505 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMHC, EMDR |
| License Number: | 367 |
| Business Practice Address: | 300 W Main St Northborough, MA - 015322132 |
| Business Phone Number: | 5083516511 |
| Business Fax Number: | |
| Mailing Address: | Po Box 439, NORTHBOROUGH |
| State: | MA |
| Postal Code: | 015320439 |
| Phone Number: | 5083516511 |
| Fax Number: | |
| NPI Enumeration Date: | 10/17/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 367 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |