MEDICARE: CELIA YOUNG CCC- SLP

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	PSLP.0000761	CO

General Provider Information

NPI Number	:	1063087625
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CELIA YOUNG CCC- SLP

Provider Business Mailing Address
First Line	:	1450 ALBION ST APT 203
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80220-2378
Country	:	US
Telephone Number	:	917-843-7575
Fax Number	:

Provider Business Practice Location Address
First Line	:	1958 ELM ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80220-1247
Country	:	US
Telephone Number	:	303-333-4982
Fax Number	:	187-750-6058

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

Provider Enumeration Date	:	05/25/2021
Last Update Date	:	04/07/2022

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Directions to “ CELIA YOUNG CCC- SLP” Practice Location

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