Provider Demographics
NPI:1689800518
Name:AUSTIN, ALMA ANN
Entity Type:Individual
Prefix:MISS
First Name:ALMA
Middle Name:ANN
Last Name:AUSTIN
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 1:1228 DUXBERRY AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43211-2229
Mailing Address - Country:US
Mailing Address - Phone:614-268-1763
Mailing Address - Fax:614-268-1763
Practice Address - Street 1:1228 DUXBERRY AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43211-2229
Practice Address - Country:US
Practice Address - Phone:614-268-1763
Practice Address - Fax:614-268-1763
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-05
Last Update Date:2009-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2908901171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator