Provider Demographics
NPI:1558674416
Name:HESSON, HOLLY JEANNE (CMT)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:JEANNE
Last Name:HESSON
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44035 RIVERSIDE PKWY
Mailing Address - Street 2:SUITE 345
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-8260
Mailing Address - Country:US
Mailing Address - Phone:703-466-0455
Mailing Address - Fax:
Practice Address - Street 1:44035 RIVERSIDE PKWY
Practice Address - Street 2:SUITE 345
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-8260
Practice Address - Country:US
Practice Address - Phone:703-466-0455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-21
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019005488225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist