Doctor Name: | MICHELE AUGUSTINE |
NPI Number: | 1235150061 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC/SLP |
License Number: | 16056 |
Business Practice Address: | 817 N. Mound St. Nacogdoches, TX - 957614427 |
Business Phone Number: | 9365646907 |
Business Fax Number: | 9365640509 |
Mailing Address: | 817 N. Mound St., NACOGDOCHES |
State: | TX |
Postal Code: | 957614427 |
Phone Number: | 9365646907 |
Fax Number: | 9365640509 |
NPI Enumeration Date: | 07/21/2006 |
NPI Last Update Date: | 02/01/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 16056 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TX |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |