Individual
TIFFANY M JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
240 TROUVILLE RD, COPIAGUE, NY 11726-3002
(516) 439-9008
Mailing address
240 TROUVILLE RD, COPIAGUE, NY 11726-3002
(516) 439-9008
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
01065601
NY
Other
Enumeration date
04/07/2022
Last updated
04/07/2022
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