NPI 1164440988

Sue Ellen Basore, MS

Practitioner Audiologist Decatur, GA

Practice location

Address: 1670 Clairmont Rd, Decatur, GA 30033-4004
Phone: (404) 329-4656
Fax: (404) 728-5074
Mailing address: 4245 Bonaparte CT, Tucker, GA 30084-2201

Registered specialties

Audiologist Primary

Speech, Language and Hearing Service Providers Taxonomy 231H00000X Licence AUD000516 (GA)

Other Audiologist providers in Georgia →

Registry record

NPI: 1164440988
Entity type: Individual
Sex (as registered): Female
NPI issued: 18 Jul 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.