Provider Demographics
NPI:1902378623
Name:NEWELL, TESSA (OTR/L)
Entity Type:Individual
Prefix:
First Name:TESSA
Middle Name:
Last Name:NEWELL
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:TESSA
Other - Middle Name:
Other - Last Name:SPENCER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3239 E COMMUNITY DR
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-8217
Mailing Address - Country:US
Mailing Address - Phone:860-689-6300
Mailing Address - Fax:
Practice Address - Street 1:301 NORTHPOINT PKWY
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-7904
Practice Address - Country:US
Practice Address - Phone:561-712-1717
Practice Address - Fax:561-712-1112
Is Sole Proprietor?:No
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19064225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist