Jennifer Lauren Austin, M.ED., CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Tucker, GA
NPI 1750721981 · NPPES record last updated Jul 2, 2013
Key facts
- NPI
- 1750721981
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SLP007234 (GA)
- Practice address
- 3756 Lavista Rd
Suite 104
Tucker, GA 30084-5614 - Phone
- (404) 477-9400
- NPI assigned
- Jul 2, 2013
- 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
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLP007234 | GA | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SLP007234 | GA | Yes |
Addresses
Primary practice location
3756 Lavista Rd
Suite 104
Tucker, GA 30084-5614
Mailing address
2795 Kimmeridge Dr
East Point, GA 30344-6800
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- Willie F Ausborn
- Kimberly Averett
- Avondale Health Services, Inc
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- Rafak Awwad
- Axess Health Solutions, LLC
All providers in Tucker, GA · Speech-Language Pathologist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 2, 2013. 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.