Provider Demographics
NPI:1962905380
Name:BESSETTE, DANIEL JAMES
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:JAMES
Last Name:BESSETTE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 MICAH CT
Mailing Address - Street 2:
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24401-6549
Mailing Address - Country:US
Mailing Address - Phone:413-563-7839
Mailing Address - Fax:
Practice Address - Street 1:30 MICAH CT
Practice Address - Street 2:
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-6549
Practice Address - Country:US
Practice Address - Phone:413-563-7839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-12
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119007190225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist