Provider Demographics
NPI:1497594519
Name:ARNOLD, TIFFANY TYRA (OTR)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:TYRA
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 W ANDERSON LN STE C100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78752-1119
Mailing Address - Country:US
Mailing Address - Phone:512-451-0961
Mailing Address - Fax:
Practice Address - Street 1:111 W ANDERSON LN STE C100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78752-1119
Practice Address - Country:US
Practice Address - Phone:512-451-0961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics