| Doctor Name: | THEODORE M AUSTIN |
| NPI Number: | 1861762437 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSYD |
| License Number: | 019934 |
| Business Practice Address: | 514 South St Bow, NH - 033043419 |
| Business Phone Number: | 6038568163 |
| Business Fax Number: | 6038568164 |
| Mailing Address: | 514 South St, BOW |
| State: | NH |
| Postal Code: | 033043419 |
| Phone Number: | 6038568163 |
| Fax Number: | 6038568164 |
| NPI Enumeration Date: | 01/12/2012 |
| NPI Last Update Date: | 06/02/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC1900X |
| License Number: | 019934 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Counseling |
| Taxonomy Definition: | |