Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Crystal Dominique Randolph, COTA/L

Individual provider Occupational Therapy Assistant · NPI 1265156426

Crystal Dominique Randolph, COTA/L is an Occupational Therapy Assistant in Mooresville, North Carolina. Works from 2 locations. Licensed in North Carolina.

Licensed in
NC
In the registry since
2022
What do these letters mean?
COTA/L — Certified Occupational Therapy Assistant, Licensed
An occupational therapy assistant who is both certified and state licensed.

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Practice location Address checks out

134 Infield Ct
Mooresville, NC 28117-8026
Phone: (704) 799-6824
Fax: (704) 799-6825
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2701 Chestnut Station Ct, Louisville, KY 40299-6395 — (800) 335-1060

Specialties & licences

Occupational Therapy Assistant (primary) Taxonomy 224Z00000X · Licence 11941 (NC)

Record details

NPI number1265156426
Entity typeIndividual (Type 1)
GenderFemale
Credentials COTA/L
Sole proprietorNo
NPI enumeratedSeptember 30, 2022
Last updated in NPPESApril 16, 2024
Certification dateApril 16, 2024

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