Healthcare Provider Details

I. General information

NPI: 1346663705
Provider Name (Legal Business Name): TESSA BILLS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/21/2014
Last Update Date: 01/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 MATCH FACTORY PL 3RD FLOOR
BELLEFONTE PA
16823-1367
US

IV. Provider business mailing address

331 TOFTREES AVE APT 223
STATE COLLEGE PA
16803-2084
US

V. Phone/Fax

Practice location:
  • Phone: 814-353-3151
  • Fax:
Mailing address:
  • Phone: 814-330-8828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW130936
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: