Provider Demographics
NPI:1285464248
Name:BESSEY, ELIZABETH ROSE
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ROSE
Last Name:BESSEY
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 1:918 CINNAMON RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84606-7111
Mailing Address - Country:US
Mailing Address - Phone:208-206-5079
Mailing Address - Fax:
Practice Address - Street 1:62 E THRIVE DR STE 210
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:UT
Practice Address - Zip Code:84045-5560
Practice Address - Country:US
Practice Address - Phone:801-766-4244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14114165-4104235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist