Provider Demographics
NPI:1578984860
Name:FITZSIMMONS, TIFFANY (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:FITZSIMMONS
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:
Other - Last Name:MANROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, OTR/L
Mailing Address - Street 1:4600 E SHEA BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-6024
Mailing Address - Country:US
Mailing Address - Phone:602-368-8601
Mailing Address - Fax:
Practice Address - Street 1:4600 E SHEA BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-6024
Practice Address - Country:US
Practice Address - Phone:602-368-8601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-03
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist