Provider Demographics
NPI:1568675098
Name:LITTLEPAGE, TIFFANY ANNE (OTR)
Entity Type:Individual
Prefix:MISS
First Name:TIFFANY
Middle Name:ANNE
Last Name:LITTLEPAGE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4121 BUCKTHORN CT
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-1100
Mailing Address - Country:US
Mailing Address - Phone:972-724-2942
Mailing Address - Fax:
Practice Address - Street 1:800 COLLEGE PKWY
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75077-3503
Practice Address - Country:US
Practice Address - Phone:972-420-8543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114043225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist