Tiffany Sims Dale, MS, OTR/L

Individual provider Active NPI Occupational Therapist · Clermont, GA

NPI 1255839072 · NPPES record last updated May 24, 2024

Key facts

NPI
1255839072
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
OT006940 (GA)
Practice address
130 Main St
Clermont, GA 30527
Phone
(678) 616-3099
Fax
(770) 406-6840
NPI assigned
Jan 26, 2018
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
OT006940GAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ability Pediatric Therapy of Gainesville LLC Multi-Specialty Current
since May 26, 2024
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist
Group: 193200000X MULTI-SPECIALTY GROUP
225X00000X OT006940 GA Yes

Addresses

Primary practice location

130 Main St
Clermont, GA 30527

Mailing address

2741 Quillians Dr
Gainesville, GA 30506-2885
Phone (678) 616-3099

Other providers in Clermont, GA

All providers in Clermont, GA · Occupational Therapist in Georgia

Sources for this page

Verify at the official NPI Registry.