Provider Demographics
NPI:1710385786
Name:ECKLAND, TIFFANY LORRAINE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:LORRAINE
Last Name:ECKLAND
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11404 W. 166TH ST.
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66062
Mailing Address - Country:US
Mailing Address - Phone:847-571-4092
Mailing Address - Fax:
Practice Address - Street 1:8115 SHAWNEE MISSION PARKWAY
Practice Address - Street 2:STE. #100
Practice Address - City:MERRIAM
Practice Address - State:KS
Practice Address - Zip Code:66202
Practice Address - Country:US
Practice Address - Phone:847-571-4092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-08
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-01757225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist