Provider Demographics
NPI:1821591785
Name:CEPLUCH, REBECCA (LMS)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:CEPLUCH
Suffix:
Gender:F
Credentials:LMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 GEORGE LEWIS CT
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:OH
Mailing Address - Zip Code:45030-4919
Mailing Address - Country:US
Mailing Address - Phone:513-309-6633
Mailing Address - Fax:
Practice Address - Street 1:8221 COLERAIN AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45239-3922
Practice Address - Country:US
Practice Address - Phone:513-309-6633
Practice Address - Fax:513-766-3773
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-16
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.023696225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist