Provider Demographics
NPI:1568210078
Name:BENTON, KORI BESS (MA, CF-SLP)
Entity type:Individual
Prefix:
First Name:KORI
Middle Name:BESS
Last Name:BENTON
Suffix:
Gender:F
Credentials:MA, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 SPRINGFIELD DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-1159
Mailing Address - Country:US
Mailing Address - Phone:859-200-3655
Mailing Address - Fax:
Practice Address - Street 1:505 SHOPPERS DR STE C
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40391-2808
Practice Address - Country:US
Practice Address - Phone:859-385-4195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist