Provider Demographics
NPI:1902461247
Name:BESSO, COURTNEY (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:BESSO
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:
Other - Last Name:ONDECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 95000-7270
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19195-7270
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1180 WELSH RD STE 150
Practice Address - Street 2:
Practice Address - City:NORTH WALES
Practice Address - State:PA
Practice Address - Zip Code:19454-2061
Practice Address - Country:US
Practice Address - Phone:267-551-3590
Practice Address - Fax:267-946-8665
Is Sole Proprietor?:No
Enumeration Date:2019-05-02
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC015862225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist