| Doctor Name: | AUSTIN T DESLAURIERS |
| NPI Number: | 1003018532 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D |
| License Number: | LP-0736 |
| Business Practice Address: | 3111 10th St Suite 105 Great Bend, KS - 675304271 |
| Business Phone Number: | 6207925227 |
| Business Fax Number: | 6207935666 |
| Mailing Address: | 670 W Barton County Rd, GREAT BEND |
| State: | KS |
| Postal Code: | 675309345 |
| Phone Number: | 6207939662 |
| Fax Number: | |
| NPI Enumeration Date: | 06/05/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TB0200X |
| License Number: | LP-0736 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KS |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Cognitive & Behavioral |
| Taxonomy Definition: | |