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Individual

TIFFANY MCDONALD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
14935 HOLLY KNOLL LN, GAINESVILLE, VA 20155-4899
(703) 743-3999
Mailing address
4116 HAMPSTEAD LN, WOODBRIDGE, VA 22192-5138
(810) 869-3061

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131001000
VA

Other

Enumeration date
02/09/2023
Last updated
02/09/2023
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