Provider Demographics
NPI:1053346239
Name:BESS, COREY ARTEDIUS (MA, CCC-SLP)
Entity type:Individual
Prefix:MR
First Name:COREY
Middle Name:ARTEDIUS
Last Name:BESS
Suffix:
Gender:M
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2330 JULIE ANN DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29505-6361
Mailing Address - Country:US
Mailing Address - Phone:843-665-1870
Mailing Address - Fax:
Practice Address - Street 1:2330 JULIE ANN DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29505-6361
Practice Address - Country:US
Practice Address - Phone:843-665-1870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3098235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSA0399Medicaid