Provider Demographics
NPI:1891482428
Name:WALKER, TIFFANY LAFAY (OTA/L)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:LAFAY
Last Name:WALKER
Suffix:
Gender:F
Credentials:OTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4831 OLD TOWER CT
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-2496
Mailing Address - Country:US
Mailing Address - Phone:513-383-3806
Mailing Address - Fax:
Practice Address - Street 1:4831 OLD TOWER CT
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-2496
Practice Address - Country:US
Practice Address - Phone:513-383-3806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA002289224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant