Provider Demographics
NPI:1457098691
Name:MOTLEY GOLDEN, TIFFANY NAME)MOTLEY
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:NAME)MOTLEY
Last Name:MOTLEY GOLDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:544 DOUGLAS ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44307-2170
Mailing Address - Country:US
Mailing Address - Phone:133-064-5578
Mailing Address - Fax:
Practice Address - Street 1:544 DOUGLAS ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44307-2170
Practice Address - Country:US
Practice Address - Phone:133-064-5578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide