Individual
TIFFANY KRISTINA BRUNDIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
6200 N KINGS HWY APT 352, ALEXANDRIA, VA 22303-2920
(706) 483-5203
Mailing address
6200 N KINGS HWY APT 352, ALEXANDRIA, VA 22303-2920
(706) 483-5203
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
A02944
MD
Other
Enumeration date
03/11/2021
Last updated
03/11/2021
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