Provider Demographics
NPI:1780159335
Name:BECKMAN, COURTNEY A (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:A
Last Name:BECKMAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5705 GREENLAND PASS
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:IN
Mailing Address - Zip Code:47143-9288
Mailing Address - Country:US
Mailing Address - Phone:812-629-5251
Mailing Address - Fax:
Practice Address - Street 1:5705 GREENLAND PASS
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:IN
Practice Address - Zip Code:47143
Practice Address - Country:US
Practice Address - Phone:812-629-5251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-10
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31006518A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist