Provider Demographics
NPI:1164968541
Name:DEL FIERRO, TIFFANY (ATR-BC, LCAT)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:DEL FIERRO
Suffix:
Gender:F
Credentials:ATR-BC, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 302
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND MILLS
Mailing Address - State:NY
Mailing Address - Zip Code:10930-0302
Mailing Address - Country:US
Mailing Address - Phone:401-229-4278
Mailing Address - Fax:
Practice Address - Street 1:55 MAIN ST
Practice Address - Street 2:SUITE 6
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924-2100
Practice Address - Country:US
Practice Address - Phone:401-229-4278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-10
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001696-1221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist