Provider Demographics
NPI:1558406207
Name:BEESON, ANDREA ELAINE (MS,CF-SLP)
Entity Type:Individual
Prefix:MISS
First Name:ANDREA
Middle Name:ELAINE
Last Name:BEESON
Suffix:
Gender:F
Credentials:MS,CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1104 11TH AVE
Mailing Address - Street 2:APARTMENT 6
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-3569
Mailing Address - Country:US
Mailing Address - Phone:304-610-5028
Mailing Address - Fax:
Practice Address - Street 1:1019 WETHERSFIELD XING
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-8719
Practice Address - Country:US
Practice Address - Phone:304-526-8897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVP SLP-0408235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist