Provider Demographics
NPI:1548721418
Name:ADAMS, TIFFANY BROOKE (OTR)
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:BROOKE
Last Name:ADAMS
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 1:5301 N BROOKLINE AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-3516
Mailing Address - Country:US
Mailing Address - Phone:405-251-2847
Mailing Address - Fax:
Practice Address - Street 1:5301 N BROOKLINE AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-3516
Practice Address - Country:US
Practice Address - Phone:405-251-2847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-25
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5321225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist