Provider Demographics
NPI:1114261690
Name:TEREBINSKI LEMP, MOLLY CATHERINE (PT)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:CATHERINE
Last Name:TEREBINSKI LEMP
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1154 S CHILDRENS HOME RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373
Mailing Address - Country:US
Mailing Address - Phone:937-405-5367
Mailing Address - Fax:
Practice Address - Street 1:323 FOREST AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402
Practice Address - Country:US
Practice Address - Phone:937-224-0793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-21
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT10997174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist