Provider Demographics
NPI:1295579548
Name:RANDALL, APRIL
Entity type:Individual
Prefix:
First Name:APRIL
Middle Name:
Last Name:RANDALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3048 CASTLETON DR
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208-5315
Mailing Address - Country:US
Mailing Address - Phone:207-944-6514
Mailing Address - Fax:
Practice Address - Street 1:THE OPENSHAW SPOT
Practice Address - Street 2:23 MAIN ST
Practice Address - City:MILLBRIDGE
Practice Address - State:ME
Practice Address - Zip Code:04658
Practice Address - Country:US
Practice Address - Phone:207-546-2880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOA4659225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist