Provider Demographics
NPI:1821717406
Name:HESSE, JENNIFER (MT-BC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:HESSE
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11925 QUEEN ST
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MD
Mailing Address - Zip Code:20759-9741
Mailing Address - Country:US
Mailing Address - Phone:240-786-8016
Mailing Address - Fax:
Practice Address - Street 1:2568A RIVA RD STE 103
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7457
Practice Address - Country:US
Practice Address - Phone:410-697-1812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-25
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist