Provider Demographics
NPI:1982151973
Name:INVERARY, TESSA
Entity Type:Individual
Prefix:
First Name:TESSA
Middle Name:
Last Name:INVERARY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12037 HALLANDALE TER
Mailing Address - Street 2:
Mailing Address - City:MITCHELLVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-1946
Mailing Address - Country:US
Mailing Address - Phone:240-280-9863
Mailing Address - Fax:
Practice Address - Street 1:4235 28TH AVE
Practice Address - Street 2:SUITE 128
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748-1718
Practice Address - Country:US
Practice Address - Phone:301-316-7806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDSC1831101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)