Individual
TIFFANY MCKIBBEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
555 BOURNE AVE, SOMERSET, KY 42501-1915
(606) 679-7421
Mailing address
195 MEADOWCREST DR, SOMERSET, KY 42503-6244
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
135357
KY
Other
Enumeration date
08/30/2018
Last updated
08/30/2018
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