Provider Demographics
NPI:1215154893
Name:TESIMALE, REBECCA (MFT)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:
Last Name:TESIMALE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12701 FOREST MILL DR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-7023
Mailing Address - Country:US
Mailing Address - Phone:804-608-8595
Mailing Address - Fax:
Practice Address - Street 1:12701 FOREST MILL DR
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-7023
Practice Address - Country:US
Practice Address - Phone:804-608-8595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist