Individual
TIFANI DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS OTR
Contact information
Practice address
303 N HURSTBOURNE PKWY STE 200, LOUISVILLE, KY 40222-5158
(502) 412-5847
Mailing address
3619 CAMELOT LN, COLUMBUS, IN 47203
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31005729A
IN
Other
Enumeration date
08/29/2014
Last updated
08/29/2014
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