Provider Demographics
NPI:1053155085
Name:BESSLING, BROOKE HAILEY
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:HAILEY
Last Name:BESSLING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613B OLD COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-4719
Mailing Address - Country:US
Mailing Address - Phone:410-868-2170
Mailing Address - Fax:
Practice Address - Street 1:877 BALTIMORE ANNAPOLIS BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-4701
Practice Address - Country:US
Practice Address - Phone:410-868-2170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician