Individual
ELISABETH S RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
2500 QUANTUM LAKES DR, SUITE 108, BOYNTON BEACH, FL 33426-8324
(561) 244-3627
(561) 244-9627
Mailing address
2500 QUANTUM LAKES DR, SUITE 108, BOYNTON BEACH, FL 33426-8324
(561) 244-3627
(561) 244-9627
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT004095
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004095
OT #
GA
Enumeration date
06/23/2006
Last updated
07/08/2007
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