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NPI Code Detail

MEDICARE: MRS. JEANNETTE C. YOUNG M.S., CCC-SLP

MEDICARE: MRS. JEANNETTE C. YOUNG M.S., 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
1235Z00000XSpeech-Language Pathologist15082TX

General Provider Information

NPI Number : 1215070206
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JEANNETTE C. YOUNG M.S., CCC-SLP
Provider Business Mailing Address
First Line : 3500 PALOMAR LN
Second Line :
City : AUSTIN
State : TX
Zip : 78727-3031
Country : US
Telephone Number : 512-467-7006
Fax Number : 512-467-7025
Provider Business Practice Location Address
First Line : 2011 W KOENIG LN
Second Line :
City : AUSTIN
State : TX
Zip : 78756-1131
Country : US
Telephone Number : 512-467-7006
Fax Number : 512-467-7025
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. JEANNETTE C. YOUNG M.S., CCC-SLP” Practice Location

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