Provider Demographics
NPI:1962832121
Name:DEMBINSKI, TERI (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:TERI
Middle Name:
Last Name:DEMBINSKI
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:MISS
Other - First Name:TERI
Other - Middle Name:
Other - Last Name:REED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:515 ELM AVE
Mailing Address - Street 2:
Mailing Address - City:DYERSBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38024-3965
Mailing Address - Country:US
Mailing Address - Phone:859-409-6368
Mailing Address - Fax:
Practice Address - Street 1:515 ELM AVE
Practice Address - Street 2:
Practice Address - City:DYERSBURG
Practice Address - State:TN
Practice Address - Zip Code:38024-3965
Practice Address - Country:US
Practice Address - Phone:859-409-6368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-25
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2063224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant