Provider Demographics
NPI:1407002173
Name:BREEN, TERESA (PT/L)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:BREEN
Suffix:
Gender:F
Credentials:PT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3277 HANNA AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45211-6848
Mailing Address - Country:US
Mailing Address - Phone:513-871-2993
Mailing Address - Fax:
Practice Address - Street 1:1960 MADISON RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45206-1828
Practice Address - Country:US
Practice Address - Phone:513-751-5880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH010256225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist