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General NPI Number Information
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NPI Number | 1487548525
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Entity Type | Individual
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Provider Name | MARCIA B AUSTIN IP
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Gender | Female
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Dates
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Enumeration Date | 06/04/2025
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 109 S 1ST E
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City | PRESTON
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State | ID
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Zip | 83263-1303
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Country | US
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Telephone | 208-852-0175
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Fax |
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Provider Business Mailing Address
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Address Line | 172 W 500 N
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City | LOGAN
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State | UT
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Zip | 84321-3929
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Country | US
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Telephone | 435-799-5367
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Fax |
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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 | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State | ID
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