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General NPI Number Information
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NPI Number | 1205325156
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Entity Type | Individual
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Provider Name | TIFFANY KAY GRINSTEAD CFY
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Gender | Female
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Dates
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Enumeration Date | 05/07/2018
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Last Update Date | 05/07/2018
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Provider Practice Location Address
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Address Line | 3815 MARQUIS PL
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City | WOODBRIDGE
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State | VA
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Zip | 22192-6228
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Country | US
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Telephone | 703-590-9874
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Fax |
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Provider Business Mailing Address
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Address Line | 1204 S WASHINGTON ST APT 313
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City | ALEXANDRIA
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State | VA
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Zip | 22314-4449
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Country | US
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Telephone | 703-590-9874
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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