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Individual
TAMARA S. KESSELMAN
Active
Individual
TAMARA S. KESSELMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
107428
MA
1041C0700X
Clinical Social Worker
Primary
107428
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107428-SW-LICSW
—
MA
01
—
1376001594
BLUE CROSS BLUE SHIELD
MA
Enumeration date
03/06/2019
Last updated
06/30/2020
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