Provider Demographics
NPI:1447749320
Name:COLLIGNON, AUSTIN DAVID (MS CCC-SLP)
Entity type:Individual
Prefix:MR
First Name:AUSTIN
Middle Name:DAVID
Last Name:COLLIGNON
Suffix:
Gender:M
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-5252
Mailing Address - Country:US
Mailing Address - Phone:201-414-7684
Mailing Address - Fax:
Practice Address - Street 1:85 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-5252
Practice Address - Country:US
Practice Address - Phone:201-414-7684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-06
Last Update Date:2018-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00946400235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist