Provider Demographics
NPI:1386889566
Name:HESSING, MARK (MA,CCC,-SLP)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:
Last Name:HESSING
Suffix:
Gender:M
Credentials:MA,CCC,-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 LAKE ST APT 3B
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10603-4005
Mailing Address - Country:US
Mailing Address - Phone:914-263-9715
Mailing Address - Fax:
Practice Address - Street 1:30 LAKE ST APT 3B
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10603-4005
Practice Address - Country:US
Practice Address - Phone:914-263-9715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3115235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist