Provider Demographics
NPI:1417727934
Name:RANDI WOLK OCCUPATIONAL THERAPY SERVICES, PLLC
Entity Type:Organization
Organization Name:RANDI WOLK OCCUPATIONAL THERAPY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RANDI
Authorized Official - Middle Name:SULLIVAN
Authorized Official - Last Name:WOLK
Authorized Official - Suffix:
Authorized Official - Credentials:MA, OTR/L
Authorized Official - Phone:919-291-5791
Mailing Address - Street 1:5930 HOURGLASS CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-3082
Mailing Address - Country:US
Mailing Address - Phone:919-291-5791
Mailing Address - Fax:
Practice Address - Street 1:5930 HOURGLASS CT
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-3082
Practice Address - Country:US
Practice Address - Phone:919-291-5791
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-05
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty