Individual
TIFFANY HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1040 MARSHALL WAY, PLACERVILLE, CA 95667-5706
(530) 622-3400
Mailing address
1040 MARSHALL WAY, PLACERVILLE, CA 95667-5706
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3194
CA
Other
Enumeration date
08/29/2016
Last updated
08/29/2016
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