Healthcare Provider Details

I. General information

NPI: 1134473556
Provider Name (Legal Business Name): TIFFANY AMBER CASH OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2012
Last Update Date: 11/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 HYLAND AVE.
MADISON WI
53792
US

IV. Provider business mailing address

600 HYLAND AVE.
MADISON WI
53792
US

V. Phone/Fax

Practice location:
  • Phone: 608-263-8060
  • Fax:
Mailing address:
  • Phone: 608-263-8060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number5233-26
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: