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Individual

TIFFANY C MCGOWN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
11077 STATE ROAD 3 APT 112, FORT WAYNE, IN 46818-0236
(260) 446-5179
Mailing address
11077 STATE ROAD 3 APT 112, FORT WAYNE, IN 46818-0236
(260) 446-5179

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001243A
IN
224Z00000X
Occupational Therapy Assistant
OTA 03454
OH
224Z00000X
Occupational Therapy Assistant
OTA 10375
FL

Other

Enumeration date
04/26/2007
Last updated
04/08/2025
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