Provider Demographics
NPI:1366845851
Name:BESS, DREMA
Entity Type:Individual
Prefix:
First Name:DREMA
Middle Name:
Last Name:BESS
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:PO BOX 172
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:25213-0172
Mailing Address - Country:US
Mailing Address - Phone:304-541-0317
Mailing Address - Fax:304-757-0192
Practice Address - Street 1:105 MAPLEWOOD ESTS
Practice Address - Street 2:
Practice Address - City:SCOTT DEPOT
Practice Address - State:WV
Practice Address - Zip Code:25560-9747
Practice Address - Country:US
Practice Address - Phone:304-541-0317
Practice Address - Fax:304-757-0192
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-29
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator