Provider Demographics
NPI:1356984512
Name:CHILDERS, AUSTIN (AUD)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:
Last Name:CHILDERS
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1630 E SHAW AVE STE 124
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-8109
Mailing Address - Country:US
Mailing Address - Phone:559-448-5633
Mailing Address - Fax:
Practice Address - Street 1:1630 E SHAW AVE STE 124
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-8109
Practice Address - Country:US
Practice Address - Phone:559-448-5633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-21
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter