Provider Demographics
NPI:1396901963
Name:HOPSON, TIFFANY DANYALE (LPTA)
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:DANYALE
Last Name:HOPSON
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1821 GLENVIEW DR SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-2413
Mailing Address - Country:US
Mailing Address - Phone:404-328-6580
Mailing Address - Fax:
Practice Address - Street 1:2525 MOSELY LANE
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30026-2413
Practice Address - Country:US
Practice Address - Phone:404-328-6580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-04
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPTA001889225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant