Individual
TESS JOELL HALVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4550 MIXSON AVE APT 12224, NORTH CHARLESTON, SC 29405-5318
(304) 376-2908
(888) 965-4405
Mailing address
650 ENTERPRISE BLVD APT 10202, CHARLESTON, SC 29492-8555
(843) 569-4546
(843) 569-4535
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6365
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14396156
CAQH
—
01
—
6365
LICENSE
SC
05
—
SA2001
—
SC
Enumeration date
09/07/2017
Last updated
11/14/2025
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