Tiffany Elmore, OTR/L

Individual provider Active NPI Occupational Therapist · Grenada, MS

NPI 1770860348 · NPPES record last updated Nov 10, 2011

Key facts

NPI
1770860348
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
OT2569 (MS)
Practice address
751 Choctaw St
Grenada, MS 38901-5317
Phone
(601) 201-8371
NPI assigned
Nov 10, 2011
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
OT2569MSMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT2569 MS Yes

Addresses

Primary practice location

751 Choctaw St
Grenada, MS 38901-5317

Mailing address

751 Choctaw St
Grenada, MS 38901-5317
Phone (601) 201-8371

Other providers in Grenada, MS

All providers in Grenada, MS · Occupational Therapist in Mississippi

Sources for this page

Verify at the official NPI Registry.