Provider Demographics
NPI:1437386422
Name:AUGUSTE-HOLDER, YANICK
Entity Type:Individual
Prefix:
First Name:YANICK
Middle Name:
Last Name:AUGUSTE-HOLDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 FIFTH ST
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-2656
Mailing Address - Country:US
Mailing Address - Phone:917-612-3767
Mailing Address - Fax:
Practice Address - Street 1:144 FIFTH ST
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-2656
Practice Address - Country:US
Practice Address - Phone:917-612-3767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-17
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY497604041235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist