Individual
CHERYL RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
111 WOODROW WILSON DR STE C, VALDOSTA, GA 31602-2583
(229) 262-4075
(229) 262-4076
Mailing address
111 WOODROW WILSON DR STE C, VALDOSTA, GA 31602-2583
(229) 262-4075
(229) 262-4076
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT007463
GA
Other
Enumeration date
10/19/2023
Last updated
10/19/2023
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