Individual
MS. SUE ELLEN BASORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
1670 CLAIRMONT RD, DECATUR, GA 30033-4004
(404) 329-4656
(404) 728-5074
Mailing address
4245 BONAPARTE CT, TUCKER, GA 30084-2201
(770) 492-9733
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AUD000516
GA
Other
Enumeration date
07/18/2006
Last updated
07/08/2007
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