Individual
NICOLE AUSTGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8690 BROADWAY STE A, MERRILLVILLE, IN 46410-7034
(219) 750-9600
Mailing address
724 E MAIN ST, LOWELL, IN 46356-1841
(219) 688-7157
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
10275009
IN
Other
Enumeration date
04/27/2023
Last updated
04/27/2023
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