MEDICARE: CHRISTINE AUST

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	103T00000X	Psychologist	PY9556	FL

General Provider Information

NPI Number	:	1669780664
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE AUST

Provider Business Mailing Address
First Line	:	7210 MANATEE AVE W # 1023
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34209-3439
Country	:	US
Telephone Number	:	941-877-0161
Fax Number	:

Provider Business Practice Location Address
First Line	:	12360 66TH ST STE 930
Second Line	:
City	:	LARGO
State	:	FL
Zip	:	33773-3434
Country	:	US
Telephone Number	:	941-877-0161
Fax Number	:

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

Provider Enumeration Date	:	09/24/2010
Last Update Date	:	12/13/2021

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Directions to “ CHRISTINE AUST ” Practice Location

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