Individual
MS. JULIA RANDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1140 W PIONEER BLVD, MESQUITE, NV 89027
(702) 346-1899
(702) 346-8581
Mailing address
PO BOX 757, MESQUITE, NV 89024
(702) 346-1899
(702) 346-8581
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
6107697-4201
UT
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
OT-2721
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D6767
—
UT
Enumeration date
11/15/2006
Last updated
11/15/2024
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