Individual
RANDI SHAKIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
8100 MIDCOUNTY HWY, GAITHERSBURG, MD 20877-5100
(301) 947-6000
Mailing address
8100 MIDCOUNTY HWY, GAITHERSBURG, MD 20877-5100
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
17474
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2251P0200X
—
MD
Enumeration date
12/05/2018
Last updated
12/05/2018
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