Healthcare Provider Details

I. General information

NPI: 1366355299
Provider Name (Legal Business Name): MARY YOUNCE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1914 HICKORY BLVD SW
LENOIR NC
28645-6470
US

IV. Provider business mailing address

3844 CHARLES WHITE LN APT 2
LENOIR NC
28645-7537
US

V. Phone/Fax

Practice location:
  • Phone: 828-728-8407
  • Fax:
Mailing address:
  • Phone: 828-850-5896
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number14067515
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: