Provider Demographics
NPI:1205325156
Name:GRINSTEAD, TIFFANY KAY (CFY)
Entity type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:KAY
Last Name:GRINSTEAD
Suffix:
Gender:F
Credentials:CFY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1204 S WASHINGTON ST APT 313
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-4449
Mailing Address - Country:US
Mailing Address - Phone:703-590-9874
Mailing Address - Fax:
Practice Address - Street 1:3815 MARQUIS PL
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-6228
Practice Address - Country:US
Practice Address - Phone:703-590-9874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-07
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist