Healthcare Provider Details

I. General information

NPI: 1023941457
Provider Name (Legal Business Name): TESSA WHITTREDGE ED. S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1160 SHERIDAN DR
LANCASTER OH
43130-1927
US

IV. Provider business mailing address

2780 COONPATH RD NE
LANCASTER OH
43130-9343
US

V. Phone/Fax

Practice location:
  • Phone: 740-687-7352
  • Fax:
Mailing address:
  • Phone: 740-687-7352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberLSP.02825
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: