Provider Demographics
NPI:1063909554
Name:LAMPE, TERA LEE
Entity type:Individual
Prefix:
First Name:TERA
Middle Name:LEE
Last Name:LAMPE
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 1:2512 LYSLE LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-1224
Mailing Address - Country:US
Mailing Address - Phone:513-289-5159
Mailing Address - Fax:
Practice Address - Street 1:615 ELSINORE PL STE 500
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-1455
Practice Address - Country:US
Practice Address - Phone:513-289-5159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-19
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator