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NPI Code Detail

MEDICARE: MRS. TRESSELA KIMBLE BATESON

MEDICARE: MRS. TRESSELA KIMBLE BATESON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1164570628
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TRESSELA KIMBLE BATESON
Provider Business Mailing Address
First Line : 100 DEVON DR
Second Line :
City : MAULDIN
State : SC
Zip : 29662-1914
Country : US
Telephone Number : 864-288-0426
Fax Number :
Provider Business Practice Location Address
First Line : 20 POWDERHORN RD
Second Line :
City : SIMPSONVILLE
State : SC
Zip : 29681-3399
Country : US
Telephone Number : 864-963-3421
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2007
Last Update Date : 07/08/2007

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