Provider Demographics
NPI:1346663705
Name:BILLS, TESSA
Entity Type:Individual
Prefix:
First Name:TESSA
Middle Name:
Last Name:BILLS
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 1:331 TOFTREES AVE
Mailing Address - Street 2:APT 223
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803-2084
Mailing Address - Country:US
Mailing Address - Phone:814-330-8828
Mailing Address - Fax:
Practice Address - Street 1:190 MATCH FACTORY PL
Practice Address - Street 2:3RD FLOOR
Practice Address - City:BELLEFONTE
Practice Address - State:PA
Practice Address - Zip Code:16823-1367
Practice Address - Country:US
Practice Address - Phone:814-353-3151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-21
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW130936104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker