Provider Demographics
NPI:1780970699
Name:DENNY, TIFFANY MICHELLE (PT)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:MICHELLE
Last Name:DENNY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:MICHELLE
Other - Last Name:TERRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:470 W HARWOOD RD
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054-2939
Mailing Address - Country:US
Mailing Address - Phone:817-498-8449
Mailing Address - Fax:
Practice Address - Street 1:470 W HARWOOD RD
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-2939
Practice Address - Country:US
Practice Address - Phone:817-498-8449
Practice Address - Fax:817-281-4829
Is Sole Proprietor?:No
Enumeration Date:2011-06-20
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1206209225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist