Provider Demographics
NPI:1821574732
Name:VONAHN, AUSTEE LYNN
Entity Type:Individual
Prefix:
First Name:AUSTEE
Middle Name:LYNN
Last Name:VONAHN
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 1:5552 HIGHWAY C
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:MO
Mailing Address - Zip Code:63461-2911
Mailing Address - Country:US
Mailing Address - Phone:573-406-8471
Mailing Address - Fax:
Practice Address - Street 1:312 MUNGER LN
Practice Address - Street 2:
Practice Address - City:HANNIBAL
Practice Address - State:MO
Practice Address - Zip Code:63401-2361
Practice Address - Country:US
Practice Address - Phone:573-248-2627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-13
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018025372235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist