Provider Demographics
NPI:1932831153
Name:HERRIDGE, TIFFANY AALIYAH (COTA/L)
Entity type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:AALIYAH
Last Name:HERRIDGE
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9750 NW 33RD STREET
Mailing Address - Street 2:SUITE 209
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065
Mailing Address - Country:US
Mailing Address - Phone:954-509-3776
Mailing Address - Fax:954-827-0308
Practice Address - Street 1:9750 NW 33RD STREET
Practice Address - Street 2:SUITE 209
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065
Practice Address - Country:US
Practice Address - Phone:954-509-3776
Practice Address - Fax:954-827-0308
Is Sole Proprietor?:No
Enumeration Date:2022-06-27
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOTA19001224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant