Healthcare Provider Details

I. General information

NPI: 1497699201
Provider Name (Legal Business Name): TIFFANY LE
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 FULTON ST
DURHAM NC
27705-3875
US

IV. Provider business mailing address

5820 FARRINGTON RD APT 212
CHAPEL HILL NC
27517-7012
US

V. Phone/Fax

Practice location:
  • Phone: 919-286-0411
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number14641
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: