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Individual
TIFFANY LEEANN HOMANT
Active
Individual
TIFFANY LEEANN HOMANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
43-2035142
TAX ID
MI
Enumeration date
03/24/2011
Last updated
03/24/2011
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