Individual
RANDI RENEE MOCNIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
103 MUSICK LN, BEAVER, WV 25813-9193
(304) 673-5805
Mailing address
PO BOX 1383, BEAVER, WV 25813-1383
(304) 673-5805
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
11/18/2024
Last updated
11/18/2024
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