Provider Demographics
NPI:1508614389
Name:AUGUSTYNIAK, ERIN (AUD)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:AUGUSTYNIAK
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-1426
Mailing Address - Country:US
Mailing Address - Phone:269-985-3738
Mailing Address - Fax:
Practice Address - Street 1:1634 GULL RD LOWR 201
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49048-1632
Practice Address - Country:US
Practice Address - Phone:269-343-2601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-08
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601001155231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist