MEDICARE: KAITLIN AUGUSTYN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	22007640A	IN

General Provider Information

NPI Number	:	1427781632
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAITLIN AUGUSTYN

Provider Business Mailing Address
First Line	:	3390 CAROLINA ST
Second Line	:
City	:	COLUMBUS
State	:	IN
Zip	:	47203-2805
Country	:	US
Telephone Number	:	812-350-0110
Fax Number	:

Provider Business Practice Location Address
First Line	:	3390 CAROLINA ST
Second Line	:
City	:	COLUMBUS
State	:	IN
Zip	:	47203-2805
Country	:	US
Telephone Number	:	812-350-0110
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2022
Last Update Date	:	07/05/2022

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Directions to “ KAITLIN AUGUSTYN ” Practice Location

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