Provider Demographics
NPI:1003105172
Name:AUSTIN, ANGELA DOLORES (TSHH)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:DOLORES
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:TSHH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 E 86TH ST APT 5C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-4782
Mailing Address - Country:US
Mailing Address - Phone:917-621-6383
Mailing Address - Fax:
Practice Address - Street 1:333 E 86TH ST APT 5C
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-4782
Practice Address - Country:US
Practice Address - Phone:917-621-6383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-29
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7433032355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant