Healthcare Provider Details

I. General information

NPI: 1093180945
Provider Name (Legal Business Name): TONEISHA N BUSH MA, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2015
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

616 EDGEFIELD RD STE 140
NORTH AUGUSTA SC
29841-6406
US

IV. Provider business mailing address

616 EDGEFIELD RD STE 140
NORTH AUGUSTA SC
29841-6406
US

V. Phone/Fax

Practice location:
  • Phone: 803-292-5200
  • Fax:
Mailing address:
  • Phone: 803-292-5200
  • Fax: 866-464-6522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP010035
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number5581
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: