Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Bethany Danielle Randall, COTA

Individual provider Occupational Therapy Assistant · NPI 1114651452

Bethany Danielle Randall, COTA is an Occupational Therapy Assistant in Jacksonville, Illinois. Licensed in Illinois. Registered with an NPI since 2022.

Licensed in
IL
In the registry since
2022
What do these letters mean?
COTA — Certified Occupational Therapy Assistant
Delivers treatment under an occupational therapist's direction.

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Practice location Address checks out

873 Grove St
Jacksonville, IL 62650-2828
Phone: (217) 479-3400
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapy Assistant (primary) Taxonomy 224Z00000X · Licence 057.005812 (IL)

Record details

NPI number1114651452
Entity typeIndividual (Type 1)
GenderFemale
Credentials COTA
Sole proprietorNo
NPI enumeratedJuly 12, 2022
Last updated in NPPESJuly 12, 2022
Certification dateJuly 12, 2022
Mailing address1076 Ne 475 Ave, White Hall, IL 62092-4024

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