Provider Demographics
NPI:1043509359
Name:ESAU, KATIE S (AUD)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:S
Last Name:ESAU
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2424 ROSWELL RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-4759
Mailing Address - Country:US
Mailing Address - Phone:678-560-0011
Mailing Address - Fax:678-560-7009
Practice Address - Street 1:2424 ROSWELL RD
Practice Address - Street 2:SUITE 6
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-4759
Practice Address - Country:US
Practice Address - Phone:678-560-0011
Practice Address - Fax:678-560-7009
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-07
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAUD003951231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist