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General NPI Number Information
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NPI Number | 1952736530
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Entity Type | Individual
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Provider Name | TIARA V ROLLE DPT
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Gender | Female
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Dates
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Enumeration Date | 09/13/2013
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Last Update Date | 08/30/2024
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Provider Practice Location Address
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Address Line | 1201 S ROSS ST
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City | ARLINGTON
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State | VA
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Zip | 22204-5071
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Country | US
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Telephone | 404-654-0414
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Fax |
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Provider Business Mailing Address
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Address Line | 300 FAVOR RD APT 7103
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-7747
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Country | US
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Telephone |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 292235
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 011129
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 070023695
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 200001293
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License Number State | DC
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Taxonomy #5
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | CP028025T
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License Number State | MD
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Taxonomy #6
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305213482
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License Number State | VA
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