Provider Demographics
NPI:1841546298
Name:BARRETT, TIFFANY (PT, DPT)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:BARRETT
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8333 S EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-2503
Mailing Address - Country:US
Mailing Address - Phone:702-263-3802
Mailing Address - Fax:702-270-7740
Practice Address - Street 1:8333 S EASTERN AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-2503
Practice Address - Country:US
Practice Address - Phone:702-263-3802
Practice Address - Fax:702-270-7740
Is Sole Proprietor?:No
Enumeration Date:2012-08-02
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2696225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist