Randall Lee Otto PHD

NPI 1629174784 - Psychologist - 103T00000X

NPI Details
NPI 1629174784
Gender Male
Enumeration Date 09/16/2006
Last Updated 07/14/2010
Entity Type Individual
Active Over 10 years ago
Practice Location
250 POND ST
BRAINTREE MA, 02184-5351, US
Phone (781) 348-3904
Fax (781) 848-1245
Business Location
250 POND ST
BRAINTREE MA, 02184-5351, US
Phone (781) 348-3904
Fax
Toxanomy
Taxonomy Code 103T00000X
License State Massachusetts
License Number 6165
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According to our database, Randall Lee Otto PHD NPI is 1629174784, taxonomy code is 103T00000X and license number is 6165, license state is located at Massachusetts. Randall Lee Otto PHD physically located at 250 Pond St, Braintree MA, 02184-5351. NPI Number Randall Lee Otto PHD has the Individual type.

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1629174784 NPI number is provided on an as is basis without warranty of any kind. 1629174784 is maintained by the National Plan & Provider Enumeration System. The contents of Randall Lee Otto PHD are for informational purposes only.