| Doctor Name: | MR. MICHAEL GUY AUGUSTINE |
| NPI Number: | 1972861144 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PC |
| License Number: | C 0900387 |
| Business Practice Address: | 2240 Winrow Ave Usa Meddac, Rwbahc Fort Huachuca, AZ - 85613 |
| Business Phone Number: | 5205332071 |
| Business Fax Number: | |
| Mailing Address: | 351 Montridge Dr, CANFIELD |
| State: | OH |
| Postal Code: | 444061230 |
| Phone Number: | 3307176526 |
| Fax Number: | |
| NPI Enumeration Date: | 04/25/2012 |
| NPI Last Update Date: | 04/25/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | C 0900387 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |