Individual
MRS. TIFFANY BLAIR DECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2400 WESTPORT PKWY STE 1300, FORT WORTH, TX 76177-5316
(817) 773-6841
Mailing address
2400 WESTPORT PKWY STE 1300, FORT WORTH, TX 76177-5316
(817) 773-6841
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
213560
TX
Other
Enumeration date
03/09/2018
Last updated
03/09/2018
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