Provider Demographics
NPI:1528455201
Name:VERES, TIFFANY RENEE (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:RENEE
Last Name:VERES
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 SHAWNEE ROAD
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805
Mailing Address - Country:US
Mailing Address - Phone:419-999-2030
Mailing Address - Fax:419-991-0909
Practice Address - Street 1:900 MANCHESTER ROAD
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:PA
Practice Address - Zip Code:16415-1703
Practice Address - Country:US
Practice Address - Phone:814-838-4822
Practice Address - Fax:814-833-8356
Is Sole Proprietor?:No
Enumeration Date:2015-04-21
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP003250L224Z00000X, 224ZR0403X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224ZR0403XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantDriving and Community Mobility
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant