Individual
NICOLE M TESKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1875 CAMPUS COMMONS DR STE 225, RESTON, VA 20191-1533
(703) 879-2482
Mailing address
11654 PLAZA AMERICA DR # 875, RESTON, VA 20190-4700
(703) 879-2483
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
07225
MD
103TC0700X
Clinical Psychologist
0810008344
VA
103TC0700X
Clinical Psychologist
Primary
LP7013
MN
Other
Enumeration date
08/06/2021
Last updated
07/08/2024
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