Provider Demographics
NPI:1255091393
Name:HOSIER, TESS KAVANAGH
Entity type:Individual
Prefix:
First Name:TESS
Middle Name:KAVANAGH
Last Name:HOSIER
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 1:252 APPIAN AVE
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-5402
Mailing Address - Country:US
Mailing Address - Phone:858-245-6954
Mailing Address - Fax:
Practice Address - Street 1:1120 LASKIN RD STE 104
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-5273
Practice Address - Country:US
Practice Address - Phone:757-650-5346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-29
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health