Individual
MS. TIFFANI KHYEL BRANDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1101 LYNDON LN, LOUISVILLE, KY 40222-4317
(502) 425-0331
Mailing address
1715 W CREEK WAY, #4, LOUISVILLE, KY 40242-3936
(502) 533-5815
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
A4952
KY
Other
Enumeration date
06/29/2013
Last updated
06/29/2013
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