Provider Demographics
NPI:1396054987
Name:SINOVIC, TIFFANY CLARE (MS, OTR/L)
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:CLARE
Last Name:SINOVIC
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48189 VAN DYKE AVE
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48317-3268
Mailing Address - Country:US
Mailing Address - Phone:586-731-9725
Mailing Address - Fax:586-488-0006
Practice Address - Street 1:13 EXECUTIVE DR
Practice Address - Street 2:SUITE 18
Practice Address - City:FAIRVIEW HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:62208-1342
Practice Address - Country:US
Practice Address - Phone:618-624-8105
Practice Address - Fax:618-624-8214
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-29
Last Update Date:2019-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201008929225XP0019X
IL056-005719225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical RehabilitationGroup - Multi-Specialty