Individual
ANGELICA TERESA RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
450 W 6TH ST, YUMA, AZ 85364-2973
(860) 459-9968
Mailing address
2651 S 8TH AVE APT 2037, YUMA, AZ 85364-7196
(860) 459-9968
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OT-046802
AZ
Other
Enumeration date
03/11/2022
Last updated
03/11/2022
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