Provider Demographics
NPI:1114340759
Name:DAY, TERESA
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:DAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2671 HIGHWAY 1103
Mailing Address - Street 2:
Mailing Address - City:CORNETTSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41731-8520
Mailing Address - Country:US
Mailing Address - Phone:606-633-9410
Mailing Address - Fax:606-436-0426
Practice Address - Street 1:2671 HIGHWAY 1103
Practice Address - Street 2:
Practice Address - City:CORNETTSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41731-8520
Practice Address - Country:US
Practice Address - Phone:606-633-9410
Practice Address - Fax:606-436-0426
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-03
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist