Provider Demographics
NPI:1114719457
Name:AMBROGI, COURTNEY WARDER (MS, OTR/L)
Entity type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:WARDER
Last Name:AMBROGI
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 OAK CIR
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-2909
Mailing Address - Country:US
Mailing Address - Phone:610-301-3444
Mailing Address - Fax:
Practice Address - Street 1:1023 E BALTIMORE PIKE STE 303
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5126
Practice Address - Country:US
Practice Address - Phone:610-301-4444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC019417225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics