Provider Demographics
NPI:1619270485
Name:BESSES, TERESA (MS)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:
Last Name:BESSES
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 N WATER ST STE 104
Mailing Address - Street 2:
Mailing Address - City:SAPULPA
Mailing Address - State:OK
Mailing Address - Zip Code:74066-2820
Mailing Address - Country:US
Mailing Address - Phone:918-224-9307
Mailing Address - Fax:
Practice Address - Street 1:9 N WATER ST STE 104
Practice Address - Street 2:
Practice Address - City:SAPULPA
Practice Address - State:OK
Practice Address - Zip Code:74066-2820
Practice Address - Country:US
Practice Address - Phone:918-224-9307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-16
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health