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NPI Code Detail

MEDICARE: DEBORAH LYNN AUSTIN LMT-CNMT

MEDICARE: DEBORAH LYNN AUSTIN LMT-CNMT
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
1101YM0800XMental Health Counselor
2225700000XMassage Therapist
3225700000XMassage Therapist99037FL

General Provider Information

NPI Number : 1417718107
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH LYNN AUSTIN LMT-CNMT
Provider Business Mailing Address
First Line : 13770 BEACH BLVD STE 4
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32224-7227
Country : US
Telephone Number : 904-470-9793
Fax Number :
Provider Business Practice Location Address
First Line : 13770 BEACH BLVD STE 4
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32224-7227
Country : US
Telephone Number : 904-470-9793
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2024
Last Update Date : 01/23/2024

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