Provider Demographics
NPI:1083076426
Name:MAUZY, TESS WHATON
Entity Type:Individual
Prefix:
First Name:TESS
Middle Name:WHATON
Last Name:MAUZY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 CRYSTAL LN
Mailing Address - Street 2:
Mailing Address - City:STRASBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22657-2370
Mailing Address - Country:US
Mailing Address - Phone:540-931-7935
Mailing Address - Fax:
Practice Address - Street 1:519 CRYSTAL LN
Practice Address - Street 2:
Practice Address - City:STRASBURG
Practice Address - State:VA
Practice Address - Zip Code:22657-2370
Practice Address - Country:US
Practice Address - Phone:540-931-7935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-24
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133002364103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst