Provider Demographics
NPI:1508266354
Name:GATES, TERESA SUE (OTR/L)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:SUE
Last Name:GATES
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:SUE
Other - Last Name:CHELLINSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:2992 BISMARK DR
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-9240
Mailing Address - Country:US
Mailing Address - Phone:614-905-6573
Mailing Address - Fax:
Practice Address - Street 1:499 E WEISHEIMER RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-2238
Practice Address - Country:US
Practice Address - Phone:614-365-8133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-29
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH007244225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist