Provider Demographics
NPI:1215235817
Name:CRAWFORD, TIFFANY ELAINE (DPT)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:ELAINE
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:ELAINE
Other - Last Name:WORSLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5208 MONTICELLO AVE
Mailing Address - Street 2:SUITE 180
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-8212
Mailing Address - Country:US
Mailing Address - Phone:757-206-1004
Mailing Address - Fax:757-645-3965
Practice Address - Street 1:5208 MONTICELLO AVE
Practice Address - Street 2:SUITE 180
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-8212
Practice Address - Country:US
Practice Address - Phone:757-206-1004
Practice Address - Fax:757-645-3965
Is Sole Proprietor?:No
Enumeration Date:2011-03-05
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305205165225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist