Provider Demographics
NPI:1538504261
Name:PITMAN, TESSA R (MS, CGC)
Entity Type:Individual
Prefix:MRS
First Name:TESSA
Middle Name:R
Last Name:PITMAN
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 TIDEWAY DR
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-3236
Mailing Address - Country:US
Mailing Address - Phone:406-422-7589
Mailing Address - Fax:
Practice Address - Street 1:1 TIDEWAY DR
Practice Address - Street 2:
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937-3236
Practice Address - Country:US
Practice Address - Phone:406-422-7589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-08
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS