Provider Demographics
NPI:1043528342
Name:LEHMPHUL, JUTTA CHRISTINE (COTA)
Entity type:Individual
Prefix:MS
First Name:JUTTA
Middle Name:CHRISTINE
Last Name:LEHMPHUL
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2246
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10949-7246
Mailing Address - Country:US
Mailing Address - Phone:845-238-1072
Mailing Address - Fax:
Practice Address - Street 1:258 RYE HILL RD
Practice Address - Street 2:APT. 3
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-4581
Practice Address - Country:US
Practice Address - Phone:845-238-1072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-20
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007153-1224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant