Individual
TIFFANY RAE MCINTYRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1800 OLD BLUEGRASS AVE, LOUISVILLE, KY 40215-1168
(502) 361-2301
Mailing address
8901 ZABEL WAY, LOUISVILLE, KY 40291-1552
(502) 299-2445
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
R3186
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100313200
—
KY
Enumeration date
02/17/2006
Last updated
09/28/2021
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