Provider Demographics
NPI:1679312375
Name:ARNDT, TIFFANY JEAN (COTA/L)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:JEAN
Last Name:ARNDT
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1028 MINNESOTA ST N
Mailing Address - Street 2:
Mailing Address - City:ORTONVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:56278-1253
Mailing Address - Country:US
Mailing Address - Phone:320-305-2493
Mailing Address - Fax:
Practice Address - Street 1:1000 N WEST AVE STE 210
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-1314
Practice Address - Country:US
Practice Address - Phone:605-403-0933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN202844224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant