Provider Demographics
NPI:1316088370
Name:LEMERE, TERESA PHYLLIS (MS, OTR-L)
Entity type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:PHYLLIS
Last Name:LEMERE
Suffix:
Gender:F
Credentials:MS, OTR-L
Other - Prefix:MRS
Other - First Name:TERRI
Other - Middle Name:PHYLLIS
Other - Last Name:LEMERE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, OTR-L
Mailing Address - Street 1:5686 SINGLETREE DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21703-8606
Mailing Address - Country:US
Mailing Address - Phone:301-694-6005
Mailing Address - Fax:
Practice Address - Street 1:5686 SINGLETREE DR
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-8606
Practice Address - Country:US
Practice Address - Phone:301-694-6005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03639225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1016583OtherNBCOT CERTIFICATION
MD03639OtherOT LICENSE&REGISTRATION
MD789RMedicaid
MD971RMedicaid