Provider Demographics
NPI:1033683669
Name:ALIU, TIFFANY LATRICE
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:LATRICE
Last Name:ALIU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1602 TERRY ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79107-3117
Mailing Address - Country:US
Mailing Address - Phone:806-437-4064
Mailing Address - Fax:
Practice Address - Street 1:1602 TERRY ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79107-3117
Practice Address - Country:US
Practice Address - Phone:806-437-4064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-16
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2097871225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant