Individual
JESSECA RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3800 INDEPENDENCE BLVD, WILMINGTON, NC 28412-2599
(910) 392-3110
Mailing address
4918 FRANKLIN AVE APT 3, WILMINGTON, NC 28403-0687
(828) 774-9840
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
NC
Other
Enumeration date
10/07/2021
Last updated
10/07/2021
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