Provider Demographics
NPI:1962025080
Name:AUSTIN THERAPY ASSOCIATES, LLC
Entity Type:Organization
Organization Name:AUSTIN THERAPY ASSOCIATES, LLC
Other - Org Name:LITTLE CANOE THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:ZURAWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:214-930-7629
Mailing Address - Street 1:7645 LAUREL OAK DR
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-5371
Mailing Address - Country:US
Mailing Address - Phone:214-930-7629
Mailing Address - Fax:678-513-6938
Practice Address - Street 1:7645 LAUREL OAK DR
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-5371
Practice Address - Country:US
Practice Address - Phone:214-930-7629
Practice Address - Fax:678-513-6938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-22
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003177557BMedicaid