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General NPI Number Information
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NPI Number | 1578635264
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Entity Type | Individual
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Provider Name | JULIA RANDLE OT
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Gender | Female
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 11/15/2024
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Provider Practice Location Address
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Address Line | 1140 W PIONEER BLVD
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City | MESQUITE
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State | NV
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Zip | 89027
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Country | US
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Telephone | 702-346-1899
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Fax | 702-346-8581
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Provider Business Mailing Address
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Address Line | PO BOX 757
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City | MESQUITE
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State | NV
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Zip | 89024
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Country | US
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Telephone | 702-346-1899
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Fax | 702-346-8581
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 6107697-4201
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number | OT-2721
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License Number State | NV
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