Tiffany P Davenport
Individual provider Active NPI Occupational Therapist · Tyrone, GA
NPI 1811701964 · NPPES record last updated Feb 6, 2025
Key facts
- NPI
- 1811701964
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- OT009394 (GA)
- Practice address
- 1130 Senoia Rd Ste A1
Tyrone, GA 30290-1640 - Phone
- (770) 207-6390
- NPI assigned
- Feb 6, 2025
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT009394 | GA | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT009394 | GA | Yes |
Addresses
Primary practice location
1130 Senoia Rd Ste A1
Tyrone, GA 30290-1640
Mailing address
1130 Senoia Rd Ste A1
Tyrone, GA 30290-1640
Phone (770) 207-6390
Other providers in Tyrone, GA
- Nyah Coulter
- Ariadne Crane
- Hayley Crawford
- Samantha Cubbler
- D-Royal Care LLC
- Donna P Decaille
- James McClellan Deckman
- Krutika Desai
- Joann Donaldson
- Dr Anna Chiropractor Services LLC
All providers in Tyrone, GA · Occupational Therapist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 6, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.