Randall Lee Otto in Braintree - Psychologist
Randall Lee Otto - NPI 1629174784
Randall Lee Otto is a Psychologist in Braintree, Massachusetts. Randall Lee Otto practices all healthcare services and medical treatments related to Psychologist. The NPI Number for Randall Lee Otto is 1629174784. The last update date is 2010-07-14.
Randall Lee Otto's current location address is 250 Pond St, Braintree, Massachusetts. You can contact this provider via phone number 7813483904. The mailing address for Randall Lee Otto is 250 Pond St, Braintree, Massachusetts. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Randall Lee Otto |
|---|---|
| Address | 250 Pond St, Braintree, Massachusetts |
| Phone Number | 7813483904 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | PHD |
NPI Number Detail
| NPI Number | 1629174784 |
|---|---|
| Provider Enumeration Date | 2006-09-16 |
| Last Updated Date | 2010-07-14 |
Provider Mailing Address Detail
| Address | 250 Pond St |
|---|---|
| City | Braintree |
| State | Massachusetts (MA) |
| Post Code | 21845351 |
| Phone Number | 7813483904 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Psychologist |
|---|---|
| Taxonomy | 103T00000X |
| Licence No | 6165 |
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Definition: A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and proce |
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What is the Randall Lee Otto's unique identification number?
The Randall Lee Otto has been assigned the NPI (National Provider Identifier) Number 1629174784 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Where is the Randall Lee Otto located?
The Randall Lee Otto is located at 250 Pond St, Braintree, MA 21845351.
What is Randall Lee Otto's specialized field of practice, and what is the corresponding taxonomy classification code?
The Randall Lee Otto's area of specialization is Psychologist, and the corresponding taxonomy code that categorizes this field of practice is 103T00000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1629174784 to Randall Lee Otto?
The Randall Lee Otto received its 1629174784 assignment from the Centers for Medicare & Medicaid Services on 2006-09-16.
When was the Randall Lee Otto's information last updated?
The Randall Lee Otto's information was last updated on 2010-07-14.