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General NPI Number Information
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NPI Number | 1093016743
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Entity Type | Individual
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Provider Name | CHERYL DIAHNN AUSTENFELD M.A
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Gender | Female
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Dates
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Enumeration Date | 11/11/2010
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Last Update Date | 11/11/2010
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Provider Practice Location Address
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Address Line | 2323 GULL ROAD
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City | RICHLAND
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State | MI
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Zip | 49083
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Country | US
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Telephone | 269-629-2213
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Fax |
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Provider Business Mailing Address
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Address Line | 6227 N 39TH ST
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City | AUGUSTA
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State | MI
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Zip | 49012-9722
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Country | US
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Telephone | 269-731-3099
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Fax | 269-731-3023
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6401011675
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number |
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License Number State | MI
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