Provider Demographics
NPI:1740951946
Name:MCCREADY, TIFFANY ANN
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:ANN
Last Name:MCCREADY
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:TIFFANY
Other - Middle Name:ANN
Other - Last Name:WOODARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:418 NORTHRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63137-3601
Mailing Address - Country:US
Mailing Address - Phone:314-498-9843
Mailing Address - Fax:
Practice Address - Street 1:700 GARDEN PATH
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63366-3052
Practice Address - Country:US
Practice Address - Phone:636-542-4302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-27
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist