Provider Demographics
NPI:1508927674
Name:AUNGST, HOLLE LYNN (AUD)
Entity Type:Individual
Prefix:DR
First Name:HOLLE
Middle Name:LYNN
Last Name:AUNGST
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:HOLLE
Other - Middle Name:AUNGST
Other - Last Name:WHITAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:9500 EUCLID AVE # A-71
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-2234
Mailing Address - Country:US
Mailing Address - Phone:216-444-7975
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE # A-71
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-2022
Practice Address - Country:US
Practice Address - Phone:216-444-7975
Practice Address - Fax:407-649-8869
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA.00413231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL086809400Medicaid
FL086809401Medicaid
OH0139588Medicaid