Provider Demographics
NPI:1750054888
Name:BASEHORE, DANA
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:BASEHORE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6080 CREEKVIEW RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-2032
Mailing Address - Country:US
Mailing Address - Phone:717-576-1468
Mailing Address - Fax:
Practice Address - Street 1:6596 ORPHANAGE RD
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:PA
Practice Address - Zip Code:17268-7804
Practice Address - Country:US
Practice Address - Phone:717-749-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist