Provider Demographics
NPI:1073142444
Name:GITTLEMAN, TESSA (LMFT)
Entity Type:Individual
Prefix:
First Name:TESSA
Middle Name:
Last Name:GITTLEMAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:TESSA
Other - Middle Name:KAI
Other - Last Name:GITTLEMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:720 WASHINGTON AVE S UNIT 422
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55415-1197
Mailing Address - Country:US
Mailing Address - Phone:612-810-1287
Mailing Address - Fax:
Practice Address - Street 1:904 MAINSTREET STE 200
Practice Address - Street 2:
Practice Address - City:HOPKINS
Practice Address - State:MN
Practice Address - Zip Code:55343-7589
Practice Address - Country:US
Practice Address - Phone:866-522-2472
Practice Address - Fax:763-717-8049
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-07
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3573106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist