Provider Demographics
NPI:1720361942
Name:KUHL, TIFFANY JANE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:JANE
Last Name:KUHL
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:JANE
Other - Last Name:ROBERTSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:1004 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52806-7602
Mailing Address - Country:US
Mailing Address - Phone:309-339-2103
Mailing Address - Fax:
Practice Address - Street 1:2545 24TH ST
Practice Address - Street 2:
Practice Address - City:ROCK ISLAND
Practice Address - State:IL
Practice Address - Zip Code:61201-5305
Practice Address - Country:US
Practice Address - Phone:309-788-0458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056009481225X00000X
IA002168225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist