Provider Demographics
NPI:1962826800
Name:CUMMINS, THERESA
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:CUMMINS
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 1:11710 DARBYSHIRE CT
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-1900
Mailing Address - Country:US
Mailing Address - Phone:513-677-9147
Mailing Address - Fax:
Practice Address - Street 1:211 N EAST ST
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-1760
Practice Address - Country:US
Practice Address - Phone:513-398-0474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-12
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT001387225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist