| NPI | 1700243615 |
|---|---|
| Former Name | TIFFANY NICOLE COCKRELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: MS TA2852) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: NC 10033) |
| 224Z00000X Occupational Therapy Assistant (Licence: SC 3510) | |
| Enumeration Date | 2016-01-22 |
| Last Update Date | 2016-01-22 |