NPI 1265156426

Crystal Dominique Randolph, COTAL

Practitioner Occupational Therapy Assistant Mooresville, NC

Practice location

Address: 134 Infield CT, Mooresville, NC 28117-8026
Phone: (704) 799-6824
Fax: (704) 799-6825

Registered specialties

Occupational Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224Z00000X Licence 11941 (NC)

Other Occupational Therapy Assistant providers in North Carolina →

Registry record

NPI: 1265156426
Entity type: Individual
Sex (as registered): Female
NPI issued: 30 Sep 2022
Record last updated: 16 Apr 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.