| Doctor Name: | DR. LORA HEIMS TESSMAN |
| NPI Number: | 1538432497 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | MA306 |
| Business Practice Address: | 82 Kirkstall Road Newtonville, MA - 024602246 |
| Business Phone Number: | 6173329778 |
| Business Fax Number: | |
| Mailing Address: | 82 Kirkstall Road, NEWTONVILLE |
| State: | MA |
| Postal Code: | 024602246 |
| Phone Number: | 6173329778 |
| Fax Number: | 6179655270 |
| NPI Enumeration Date: | 02/22/2012 |
| NPI Last Update Date: | 02/22/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | MA306 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |