Joanna Gail Augustus
Individual provider Active NPI Developmental Therapist · Versailles, IL
NPI 1497541379 · NPPES record last updated Apr 16, 2025
Key facts
- NPI
- 1497541379
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Developmental Therapist 222Q00000X
- Practice address
- 1667 365N Ave
Versailles, IL 62378-2107 - Phone
- (207) 651-7882
- NPI assigned
- Apr 16, 2025
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | Yes |
Addresses
Primary practice location
1667 365N Ave
Versailles, IL 62378-2107
Mailing address
1667 365N Ave
Versailles, IL 62378-2107
Phone (207) 651-7882
Other names
- Joanna Gail Moreau
Other providers in Versailles, IL
All providers in Versailles, IL · Developmental Therapist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 16, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.