MEDICARE: MS. CHARMAINE YOUNG

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	235Z00000X	Speech-Language Pathologist	SLP000135	DC

General Provider Information

NPI Number	:	1871825588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHARMAINE YOUNG

Provider Business Mailing Address
First Line	:	8750 GEORGIA AVE APT 1227A
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-3692
Country	:	US
Telephone Number	:	336-340-7185
Fax Number	:

Provider Business Practice Location Address
First Line	:	8750 GEORGIA AVE APT 1227A
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-3692
Country	:	US
Telephone Number	:	336-340-7185
Fax Number	:

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

Provider Enumeration Date	:	02/04/2010
Last Update Date	:	02/04/2010

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Directions to “ MS. CHARMAINE YOUNG ” Practice Location

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