Individual
MRS. LISA RAE AUGUSTINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
8170 HOLLOW ROAD, MIDDLETOWN, MD 21769
(301) 371-3474
(301) 371-6722
Mailing address
8170 HOLLOW ROAD, MIDDLETOWN, MD 21769
(301) 371-3474
(301) 371-6722
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
06591
MD
Other
Enumeration date
09/27/2011
Last updated
09/27/2011
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