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1326415597 NPI number — LORI L TESELLE-DELISA MA

NPI Number: 1326415597
Health Care Provider/Practitioner: LORI L TESELLE-DELISA MA

Information about “1326415597” NPI (LORI L TESELLE-DELISA MA) exists in 1326415597 in HTML format HTML  |  1326415597 in plain Text format TXT  |  1326415597 in PDF (Portable Document Format) PDF  |  1326415597 in an XML format XML  formats.

NPI Number : 1326415597 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1326415597",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "TESELLE-DELISA",
    "FirstName": "LORI",
    "MiddleName": "L",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MA",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "TESELLE",
    "OtherFirstName": "LORI",
    "OtherMiddleName": "L",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "MS",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "2223 S MERIDIAN",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PUYALLUP",
    "MailingAddressStateName": "WA",
    "MailingAddressPostalCode": "98371-7503",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "253-355-2467",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2223 S MERIDIAN",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PUYALLUP",
    "PracticeLocationAddressStateName": "WA",
    "PracticeLocationAddressPostalCode": "98371-7503",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "253-355-2467",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/24/2015",
    "LastUpdateDate": "08/14/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "106H00000X",
        "TaxonomyName": "Marriage & Family Therapist",
        "LicenseNumber": "LF60910751",
        "LicenseNumberStateCode": "WA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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