Provider Demographics
NPI:1346768074
Name:TESMAN, JOHANNA RICH (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOHANNA
Middle Name:RICH
Last Name:TESMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 WALNUT BOTTOM RD STE 311
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17015-7766
Mailing Address - Country:US
Mailing Address - Phone:717-243-1511
Mailing Address - Fax:717-243-1530
Practice Address - Street 1:1200 WALNUT BOTTOM RD STE 311
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17015-7766
Practice Address - Country:US
Practice Address - Phone:717-243-1511
Practice Address - Fax:717-243-1530
Is Sole Proprietor?:No
Enumeration Date:2017-09-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS008357L103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent