MEDICARE: TONEISHA N BUSH MA, CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SLP010035	GA
2	235Z00000X	Speech-Language Pathologist	5581	SC

General Provider Information

NPI Number	:	1093180945
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONEISHA N BUSH MA, CCC-SLP

Provider Business Mailing Address
First Line	:	616 EDGEFIELD RD STE 140
Second Line	:
City	:	NORTH AUGUSTA
State	:	SC
Zip	:	29841-6406
Country	:	US
Telephone Number	:	803-292-5200
Fax Number	:	866-464-6522

Provider Business Practice Location Address
First Line	:	616 EDGEFIELD RD STE 140
Second Line	:
City	:	NORTH AUGUSTA
State	:	SC
Zip	:	29841-6406
Country	:	US
Telephone Number	:	803-292-5200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/03/2015
Last Update Date	:	12/04/2025

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Directions to “ TONEISHA N BUSH MA, CCC-SLP” Practice Location

Language	Start Address	Practice Location

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