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Individual

SUSAN J HANSBOROUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AUDIOLOGIST

Contact information

Practice address
243 WOODROW WILSON AVE, CREDENTIALING, FISHERSVILLE, VA 22939
(540) 332-7087
Mailing address
PO BOX 1500, BOX W-1, CREDENTIALING, FISHERSVILLE, VA 22939
(540) 332-7087

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
2201000144
VA
237600000X
Audiologist-Hearing Aid Fitter
2101000806
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004980107
VA
05
009451528
VA
Enumeration date
04/06/2006
Last updated
08/28/2009
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