Provider Demographics
NPI:1508920687
Name:BESIER, SKYE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SKYE
Middle Name:
Last Name:BESIER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:SKYE
Other - Middle Name:
Other - Last Name:WILHARM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:1500 LOOP RD
Mailing Address - Street 2:
Mailing Address - City:VIDALIA
Mailing Address - State:GA
Mailing Address - Zip Code:30474-8524
Mailing Address - Country:US
Mailing Address - Phone:912-537-0813
Mailing Address - Fax:
Practice Address - Street 1:1500 LOOP RD
Practice Address - Street 2:
Practice Address - City:VIDALIA
Practice Address - State:GA
Practice Address - Zip Code:30474-8524
Practice Address - Country:US
Practice Address - Phone:912-537-0813
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP005901235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist