Provider Demographics
NPI:1942005806
Name:GARRETT, TIFFANY DEAN (LMT)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:DEAN
Last Name:GARRETT
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDER CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35010-2525
Mailing Address - Country:US
Mailing Address - Phone:256-307-7079
Mailing Address - Fax:
Practice Address - Street 1:119 MADISON ST
Practice Address - Street 2:
Practice Address - City:ALEXANDER CITY
Practice Address - State:AL
Practice Address - Zip Code:35010-2525
Practice Address - Country:US
Practice Address - Phone:256-307-7079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6541225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist