Provider Demographics
NPI:1699415760
Name:AUGUSTINE, MUNYEE
Entity Type:Individual
Prefix:
First Name:MUNYEE
Middle Name:
Last Name:AUGUSTINE
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 1:1701 LAMY LN
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-3737
Mailing Address - Country:US
Mailing Address - Phone:318-329-0240
Mailing Address - Fax:318-732-0239
Practice Address - Street 1:1701 LAMY LN
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-3737
Practice Address - Country:US
Practice Address - Phone:318-329-0240
Practice Address - Fax:318-732-0239
Is Sole Proprietor?:No
Enumeration Date:2022-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator